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Breast Cancer (Expert Forum)
ER/PR -
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
ER/PR -
by Her2nue, Nov 05, 2003 12:00AM
Does hormone therapy only help prevent a reoccurence in the breasts? Is breast cancer either ER+ or ER-, or are there degrees of how slightly or strongly a cancer is positive? Are there any benefits to hormone therapy (Aridimex) if the cancer is ER-?
Thank you
Thank you
Doctor's Answer
by CCF-RN,MSN-JS, Nov 05, 2003 12:00AM
Dear Her2nue, 1) The idea behind the use of hormone therapy in treating breast cancer is to decrease estrogen levels in the body that may stimulate the growth of cancer. Hormone therapy is used after surgery to try to prevent or minimize the growth of microscopic deposits of tumor cells that might grow into a recurrent tumor, it is also used in cases of metastatic breast cancer to control the growth of disease.
2)Pathologists use several techniques to test hormone receptors on tissue, and determine if the breast cancer cells respond, or attach, to estrogen receptors and progesterone receptors on the cell. Breast cancer is termed ER (or PR)-positive if its cells have more than a pre-specified baseline “cutoff” level of hormone receptors - the more a breast cancer responds, the higher its numerical test score. The reverse is also true: breast cancers with test scores at or around the cutoff level are called “weakly” ER (or PR)-positive, and those scoring below the cutoff are called ER (or PR)-negative - meaning that hormones do not stimulate the cancer’s growth.
Over the years the methods of testing for estrogen receptors has changed and most hospitals will have arbitrarily chosen 10% or even 20% (of tumor cells expressing ER or PR) as their cutoff for defining positivity.
The same type and dose of hormonal therapy is generally used for any breast cancer that is classified as ER-positive, even if it has a “weak” degree of positivity (test results close to the cutoff level).
3) Arimidex (anastrozole) is used only in estrogen receptor positive disease. Its mechanism of action (the way it works)is to interfere with the conversion of androgens to estrogens, thus decreasing estrogen levels in the body. Based on this there would be no benefit to using it if the cancer does not have estrogen receptors.
2)Pathologists use several techniques to test hormone receptors on tissue, and determine if the breast cancer cells respond, or attach, to estrogen receptors and progesterone receptors on the cell. Breast cancer is termed ER (or PR)-positive if its cells have more than a pre-specified baseline “cutoff” level of hormone receptors - the more a breast cancer responds, the higher its numerical test score. The reverse is also true: breast cancers with test scores at or around the cutoff level are called “weakly” ER (or PR)-positive, and those scoring below the cutoff are called ER (or PR)-negative - meaning that hormones do not stimulate the cancer’s growth.
Over the years the methods of testing for estrogen receptors has changed and most hospitals will have arbitrarily chosen 10% or even 20% (of tumor cells expressing ER or PR) as their cutoff for defining positivity.
The same type and dose of hormonal therapy is generally used for any breast cancer that is classified as ER-positive, even if it has a “weak” degree of positivity (test results close to the cutoff level).
3) Arimidex (anastrozole) is used only in estrogen receptor positive disease. Its mechanism of action (the way it works)is to interfere with the conversion of androgens to estrogens, thus decreasing estrogen levels in the body. Based on this there would be no benefit to using it if the cancer does not have estrogen receptors.
