Hormone Receptor Status
Many breast cancer tumors have receptors for estrogen and/or progesterone, often in large numbers. These tumors are said to be hormone-dependent, and estrogen and/or progesterone feed their growth. Breast cancer tissue can be tested to see if it is positive for these receptors.
How is the sample collected for testing?A sample of breast cancer tissue is obtained by doing a fine needle aspiration, needle biopsy, or surgical biopsy or when a tumor removed surgically during a lumpectomy or mastectomy is tested.
Is any test preparation needed to ensure the quality of the sample?Your doctor may have you discontinue taking hormones for a time period before your sample is collected.
How is it used?Estrogen and progesterone hormone receptor status tests are typically performed on all invasive breast cancers. Hormone receptor status is used as a prognostic marker, and used to help guide the treatment of people with primary or recurrent breast cancer.
Those who have ER-positive and PR-positive tumors tend to have a better prognosis for disease-free survival and overall survival than those with ER-negative or PR-negative tumors. They are also much more likely to respond to endocrine therapy (anti-hormone treatments such as tamoxifen).
When is it ordered?Hormone receptor status testing is recommended as part of an initial workup of invasive breast cancer. It is not diagnostic but helps the doctor to determine treatment options and to understand more about the tumor's characteristics.
What does the test result mean?In general, if a person's cancer is ER-positive and PR-positive, the patient will have a better-than-average prognosis, and their cancer is likely to respond to endocrine therapy (anti-hormone treatments). The more receptors present and the more intense their reaction, the more likely the response. If a person's cancer is ER-negative but PR-positive, or ER-positive but PR-negative, then she may still benefit from endocrine therapy but may have a diminished response.
If the cancer is both ER-negative and PR-negative, then the person will probably not benefit from endocrine therapy.
An individual's response to endocrine therapy will depend on a variety of factors, but typical response rates include:
- ER positive, PR positive: 75-80%
- ER positive, PR negative: 40-50%
- ER negative, PR positive: 25-30%
- ER negative, PR negative: 10% or less
Is there anything else I should know?Her-2/neu testing may be done at the same time as hormone receptor status testing. A patient with a positive estrogen and/or progesterone receptor status may find their response to endocrine therapy diminished if they are also Her-2/neu-positive.
Hormone receptor status testing is not available in every laboratory. It requires experience and special training to perform and interpret. Your doctor will probably send your sample to a reference laboratory and it may take several weeks before your results are available.
It takes a small amount of cancer tissue to perform hormone receptor status testing. If a sufficient sample is not available, your doctor may make an assumption that your cancer is ER-positive and PR-positive in order to broaden your treatment options.
Is there a blood test that can be done to check my hormone receptor status?No. The cancer cells do not "shed" the receptors, so they are not detectable in the blood. They must be evaluated in the cancer tissue itself.
Would this testing also be performed on a man?