Quantitative image analysis of estrogen and progesterone receptors as a prognostic tool for selecting breast cancer patients for therapy

OBJECTIVE: To assess estrogen and progesterone receptor presence in human b reast tumors using immunocytochemical analysis. STUDY DESIGN For both estrogen (ER) and progesterone (PR) receptor assay, p ercent of stained cells and intensify of staining were estimated on a serie s of 251 consecutive breast cancer cases from the M. Ascoli Cancer Hospital Center in Palermo using the CAS 200 image analysis system. RESULTS: Cytochemical assay revealed a differential distribution of both ER and PR, by menopausal status of the patients; premenopause (PreM) was most ly EX negative (63%), and postmenopause (PostM) > 10 years was mostly ER an d PR positive (64%). The percent of cells stained for ER was significantly different between PreM and PostM patients when they were considered as a wh ole. By contrast, no difference emerged for PX staining among menopausal gr oups. Overall, patients whose tumors were PR positive showed a significantl y (P < .03) longer interval free of relapse. CONCLUSION: The present results suggest that PRs behave as better indicator s than ERs of early relapse in breast cancer patients. Further studies, wit h longer follow-up, are needed, however, to validate this concept.