THE STABILITY OF ESTROGEN AND PROGESTERONE RECEPTORS IN PATIENTS RECEIVING PREOPERATIVE CHEMOTHERAPY FOR LOCALLY ADVANCED BREAST-CARCINOMA

The determination of estrogen (ER) and progesterone receptor (PR) cont ent is routine in the management of carcinoma of the breast. Such data are commonly used to predict responses to endocrine therapy. Preopera tive chemotherapy is often utilized in the treatment of patients with locally advanced carcinoma of the breast. However, little attention ha s been focused upon the effect of preoperative chemotherapy on hormona l receptor expression in that setting. The purpose of this study is to evaluate the effect of preoperative chemotherapy on ER and PR express ion in patients with locally advanced breast carcinoma. Patients with T3 or T4 adenocarcinoma of the breast from Charity Hospital in New Orl eans were studied. Levels of ER and PR were determined from tissue blo cks obtained at diagnostic biopsy, as well as after the preoperative c hemotherapy. The receptor levels were determined using immunohistochem istry and quantified using image analysis. We evaluated 21 locally adv anced cancer patients who received at least three cycles of standard c hemotherapy regimens. Of these patients, 11 achieved a partial respons e, with 3 achieving a complete response after preoperative chemotherap y. A total of 33 per cent of patients had a significant change in horm onal receptor content after preoperative chemotherapy. ER changed in 1 7%, PR in 22%, and both ER and PR in 6%. These data show that ER and/o r PR expression changed in 33% of patients studied. Further, ER and PR status does not appear to predict or correlate with response to chemo therapy. This suggests that determination of ER and PR may best be per formed from definitive resection specimens in patients who receive pre operative chemotherapy.