Quantitative estrogen receptor (ER) values in patients with breast carcinoma were correlated with the natural history of the disease before surgical intervention. The natural history was expressed as an index of growth. This was determined as a ratio between tumor size (centimeters) and duration of symptoms (weeks). An inverse correlation was found between amount of ER and growth. Tumors with high positive (above 101 fmol/mg protein) ER values had grown significantly slower (P < 0.05) than tumors with low positive (below 50 fmol/mg protein) or negative ER values. These two latter groups had a similar natural history. Recognition of the fact that there is slow growth in carcinomas with high ER as well as of the fact that growth is as rapid in carcinomas with low ER levels as it is in carcinomas with negative ER values, demonstrates the importance of quantitative ER determinations, their prognostic value, and their usefulness in planning therapy.
Cancer 50:793-796. 1982.
UANTITATIVE AMOUNTS of estrogen receptor (ER)
Q correlate much more closely'-' with hormonal response rate than does the mere presence or absence of ER.4 Similarly, the potential growth rate of breast carcinoma, measured in vitro, shows an intimate relationship with amount of Growth before surgical intervention or the natural history of the tumor is an underutilized but almost always readily available means of estimating how a carcinoma of the breast has behaved up to the time of diagnosis. As rate of growth of carcinoma of the breast is assumed to be constant,' the growth before surgical intervention is comparable with the manifestations of clinical growth such as disease-free interval,*v9 recurrence rate,'." and ~u r v i v a l , ~~' ~ all of which have been favorably influenced by the presence of ER. However, a relationship between quantitative amount of estrogen receptor and clinical growth has not yet been established.
This study correlates quantitative amounts of estrogen receptor in premenopausal and postmenopausal patients with growth of carcinoma of the breast before surgical intervention.
Materials and Methods
This study is based on 81 female patients with primary ductal (NOS) and lobular breast carcinoma, Stages I, I1 and 111, which were assayed for estrogen