The effect of neoadjuvant chemotherapy on estrogen and progesterone receptor expression and hormone receptor status in breast cancer

Lee, Susan H; Chung, Maureen A; Quddus, M.Ruhul; Steinhoff, Margaret M; Cady, Blake

doi:10.1016/S0002-9610(03)00271-X

« Previous Next »The American Journal of Surgery
Volume 186, Issue 4 , Pages 348-350, October 2003

The effect of neoadjuvant chemotherapy on estrogen and progesterone receptor expression and hormone receptor status in breast cancer

Presented at the Fourth Annual Meeting of the American Society of Breast Surgeons, Atlanta, Georgia, April 30–May 4, 2003

Susan H Lee, M.D.
- The Breast Health Center, Program in Women's Oncology, Women and Infants Hospital, 101 Dudley St., Providence, RI 02905, USA
Maureen A Chung, M.D., Ph.D.
- The Breast Health Center, Program in Women's Oncology, Women and Infants Hospital, 101 Dudley St., Providence, RI 02905, USA
- Department of Surgery, Brown University, Providence, RI, USA
- Corresponding author. Department of Surgery, Rhode Island Hospital, 593 Eddy Street, APC 4, Providence, RI 02903. Tel.: +1-401-444-6158; fax: +1-401-444-6681.
M.Ruhul Quddus, M.D.
- The Breast Health Center, Program in Women's Oncology, Women and Infants Hospital, 101 Dudley St., Providence, RI 02905, USA
- Department of Pathology, Brown University, Providence, RI, USA
Margaret M Steinhoff, M.D.
- The Breast Health Center, Program in Women's Oncology, Women and Infants Hospital, 101 Dudley St., Providence, RI 02905, USA
- Department of Pathology, Brown University, Providence, RI, USA
Blake Cady, M.D.
- The Breast Health Center, Program in Women's Oncology, Women and Infants Hospital, 101 Dudley St., Providence, RI 02905, USA
- Department of Surgery, Brown University, Providence, RI, USA

Received 3 June 2003; received in revised form 21 June 2003

Abstract

Background

Neoadjuvant chemotherapy may decrease tumor volume to allow breast conservation surgery. Its effect on estrogen and progesterone receptor (ER/PR) expression and hormone receptor (HR) status is controversial.

Methods

From February 2001 to July 2002, 56 breast cancer patients treated with neoadjuvant chemotherapy and 56 non-neoadjuvant therapy (control) patients with adequate tissue samples were identified. Quantitative ER/PR expression was analyzed in preneoadjuvant or preoperative core biopsies and final surgical specimens. Changes between the two groups were compared to determine if alterations were due to neoadjuvant chemotherapy or tissue sampling.

Results

The ER/PR expression changed in 34 (61%) neoadjuvant chemotherapy patients and 27 (48%) control patients. These expression changes resulted in HR status (positive/negative) alterations in 3 patients (5%) in both groups. Age, histology, chemotherapy regimen, and neoadjuvant response did not predict change.

Conclusions

Hormone receptor status changed in 5% of neoadjuvant chemotherapy and control groups due to tissue sampling. As these changes may impact treatment, HR expression reanalysis in final surgical specimens is recommended.

Keywords: Neoadjuvant chemotherapy, Hormone receptor status, Breast cancer