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Home What is Breast Cancer Types of Breast Cancer Single Hormone Receptor Positive Breast Cancer

Single Hormone Receptor Positive Breast Cancer

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WHAT IF MY CANCER IS POSITIVE FOR JUST A SINGLE HORMONE RECEPTOR! DO I STILL GET BENEFITS OF A HORMONE POSITIVE CANCER?
There are two hormone receptors estrogen receptor ER and progesterone receptor PR. This can be found in your pathology report, reported as ER: x%, PR: y%. The behavior of a tumor as well as its treatment is majorly influenced by these results.
The presence of both these receptors/switches (ER and PR) is good news. These switches can be easily turned off with hormonal therapy, and tumor growth is suppressed. Hormonal therapy is considered to be milder than other forms of anticancer therapy with minimal side-effects. A breast tumor with the presence of these switches is also considered to have a good prognosis. Patients have a longer survival and lesser chances of the disease coming back (recurrence). 
 If a tumor is positive for both estrogen and progesterone receptor (ER+/PR+), it would get benefits of a hormone receptor positive cancer (i.e. it can be easily dealt with hormonal therapy which is non- toxic with minimal side effects and has good prognosis).

ER+/PR- TUMOR:
If your tumor is positive for estrogen receptor but negative for progesterone receptor (ER+/PR-), it does not get benefits of a hormone positive cancer. The positive ER is misleading in such cases. These tumors are in fact more aggressive with a poor prognosis as compared to ER+/PR+ tumors and are resistant to Tamoxifen, which is a commonly used hormonal therapy. They require a different treatment approach, which your doctor shall discuss with you.  Various factors then play a role in choosing an appropriate therapy and it differs on individual bases.
 This subtype is frequently seen in postmenopausal women and women more than 60 years old. Patients with diets rich in high glycemic index foods (that cause a rapid surge in blood sugar, e.g., potatoes, bread) had a 44% greater risk for developing ER+/PR- tumors than patients with diets rich in low glycemic index food (that cause a gradual increase in blood sugar, e.g., high-fiber cereals, beans).
Women with ER+/PR- tumors, when switched over to a healthy lifestyle, consisting of high fruit and vegetable consumption with high levels of physical activity, had significantly longer survival times than women consuming low levels of fruits and vegetables with low levels of physical activity (1).

ER-/PR+ TUMORS:
This subtype rarely reported and is unlikely to actually exist. It is thought to be reported due to technical errors which results in a false negative ER (i.e. even if ER is positive, a test would report it negative due to methodological problems) (2).

CONCLUSION:
It is very essential to know the presence and quantity of hormone receptors in your tumor. Different permutations and combinations of tumor receptors/switches results in variable tumor behavior.  The receptor status may change if the tumor recurs and may be different in each tumor, if more than one tumor is present in a breast. The single hormone receptor positive variety, particularly ER+/PR- is challenging to deal with and research in this area is ongoing.

DR. JIGISHA P THAKKAR - MBBS
VISITING RESEARCH ASSOCIATE
UNIVERSITY OF ILLINOIS MEDICAL CENTER


DIVYESH G MEHTA

REFERENCES
1) A review of an unfavorable subset of breast cancer: estrogen receptor positive progesterone receptor negative. Thakkar JP, Mehta DG. PMID:  21339261 
2) Molecular profiles of progesterone receptor loss in human breast tumors. Creighton CJ, Kent Osborne C. PMID:  18425577