CHANGING ESTROGEN AND PROGESTERONE-RECEPTOR PATTERNS IN BREAST-CARCINOMA DURING THE MENSTRUAL-CYCLE AND MENOPAUSE

BACKGROUND, Estrogen receptor (ER) and progesterone receptor (PgR) sta tus at the time of breast carcinoma surgery is used as a marker of bot h prognosis and hormone dependency to guide adjuvant therapy. The auth ors studied the influence of hormonal milieu at the time of surgery on ER and PgR levels. METHODS. A population of 2020 patients with breast carcinoma, including 575 premenopausal women, was analyzed. ER and Pg R levels were determined by radioligand binding assays (cutoff values, 10 fmol/mg). Serum estradiol (E2), progesterone (Pg), follicle-stimul ating hormone (FSH), and luteinizing hormone (LH) levels obtained on t he day of surgery were used to define the menstrual cycle phase in pre menopause. RESULTS, In premenopause, there was a higher proportion of ER positive (ER+) tumors in the follicular phase (62%, n = 316) than i n the ovulatory phase (51%, n = 59) and the luteal phase (53%, n = 200 , P = 0.03). The mean ER level was also higher in the follicular phase (30 fmol/mg) than in the ovulatory phase (20 fmol/mg) and the luteal phase (25 fmol/mg, P < 0.001). The percentage of PgR positive (PgR(+)) tumors tended to be higher in the ovulatory phase (85%) than in the f ollicular (78%) and luteal (72%) phases (P = 0.11). The mean PgR was a lso higher in the ovulatory phase (177 fmol/mg) than in the follicular and luteal phases (134 and 92 fmol/mg, respectively; P < 0.001). The percentage of ER+ tumors was higher among menopausal women than among premenopausal women (67% vs. 59%, respectively; P < 0.001). Conversely , the percentage of PgR(+) tumors was lower among menopausal women tha n among premenopausal women (65% vs. 78%, respectively; P < 0.001). In premenopause, there was a weak negative correlation between ER and E2 levels. No correlations were found between levels of ER and Pg and le vels of FSH and LH or among levels of PgR and E2, Pg, and FSH and LH i n premenopausal and menopausal women. CONCLUSIONS, Changes in ER and P gR levels in breast carcinoma during the menstrual cycle and menopause suggest that interpretations of hormone dependency on the basis of st eroid receptor values should take into account hormonal status at the time of surgery. Cancer 1998;83:698-705, (C) 1998 American Cancer Soci ety.