STEROID-RECEPTORS IN CARCINOMA OF THE BREAST - RESULTS OF IMMUNOCYTOCHEMICAL AND BIOCHEMICAL DETERMINATION AND THEIR EFFECTS ON SHORT-TERM PROGNOSIS

A group of 241 nonpretreated breast carcinomas was studied for estroge n receptor (ER) and progesterone receptor (PR) content by both immunoc ytochemistry (ICC) and biochemical analysis (dextran-coated charcoal [ DCC]). While the tumors were judged to be ER positive in 67.6% and PR positive in 65.6% by ICC, DCC analysis showed positive results in 77.6 % for both ER and PR. There was only a moderate correlation between th e semiquantitative results of ER and PR ICC and the corresponding valu es for DCC receptor determination. Among tumors shown to be steroid re ceptor positive by ICC, a majority showed a wide spectrum of staining intensity, from negative to intensely positive (type C staining patter n, ER 87.7%, PR 73.4%). Less frequently, carcinomas showing uniform, i ntense staining of all epithelial tumor cells were observed (type A st aining pattern, ER 11.7%, PR 18.4%). Finally, only very few tumors had both clearly negative and distinctly positive cells (type B staining pattern, ER 0.6%, PR 8.2%). On analyzing the relationship between the expression of steroid receptors (ICC and DCC) and the prognostic facto rs axillary node status, tumor size, tumor histology, grade and patien t age, only a significant correlation between patient age and ER (ICC, r=.46; DCC, r=.43), a weakly significant negative correlation between node involvement and ER, and a weakly significant negative correlatio n between tumor grade and ER (ICC only) as well as between tumor grade and PR were found. Among all patients, the recurrence-free interval w as significantly longer in patients with ER- or PR-positive carcinomas (ICC and DCC). A similar tendency-however, without reaching statistic al significance-toward longer recurrence-free survival was found both among node-positive (N1) and -negative (N0) patients if steroid recept or status was determined by ICC. If ER and PR were determined by DCC, N1 patients with receptor-positive tumors had significantly longer rec urrence-free intervals; however, no recognizable prognostic effect of ER or PR was seen among N0 cases.