TY - JOUR
T1 - Borderline ER-Positive Primary Breast Cancer Gains No Significant Survival Benefit From Endocrine Therapy
T2 - A Systematic Review and Meta-Analysis
AU - Chen, Tong
AU - Zhang, Ning
AU - Moran, Meena S.
AU - Su, Peng
AU - Haffty, Bruce G.
AU - Yang, Qifeng
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/2
Y1 - 2018/2
N2 - Endocrine responsiveness of primary breast cancers with borderline estrogen receptor expression (ER + [1%-9%]) remains unclear. We aimed at investigating differences in endocrine responsiveness, prognosis, and clinicopathological characteristics between the ER + (1%-9%) cohort and the ER − cohort or ER + (≥10%) cohort. Eligible literature published from inception to November 20, 2016 was retrieved from the PubMed database on the basis of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data on survival outcomes were extracted and pooled odds ratios (ORs), 95% confidence intervals (CIs), and 2-tailed P values are reported. P values of the χ 2 test for comparison of clinicopathological characteristics among included patients in the ER + (1%-9%) cohort and the other 2 cohorts were calculated respectively. The analysis included 6 studies with 16,606 patients. Significant differences were detected between the ER + (1%-9%) cohort and the other 2 cohorts on the basis of clinicopathological characteristics respectively. When taking all of the patients into analysis without consideration of treatment modality, the ER + (1%-9%) cohort presented better prognosis than the ER − group in terms of 5-year disease-free survival (OR, 1.47; P =.046) and 5-year overall survival (OR, 1.23; P =.046). However, patients with ER + (1%-9%) breast cancer who received endocrine therapy seemed to have a prognosis similar to those without any endocrine therapy (P =.684) and those with ER − carcinoma who received endocrine therapy (P =.145). Patients with ER + (≥10%) tumors had better endocrine responsiveness compared with their ER + (1%-9%) counterparts (OR, 0.52; P =.034, ER + [1%-9%] vs. ER + [≥10%]). Our results indicate that primary breast cancer patients with ER + (1%-9%) expression gained no significant survival benefit from endocrine therapy, but manifested overall better prognosis than those with ER − cancer.
AB - Endocrine responsiveness of primary breast cancers with borderline estrogen receptor expression (ER + [1%-9%]) remains unclear. We aimed at investigating differences in endocrine responsiveness, prognosis, and clinicopathological characteristics between the ER + (1%-9%) cohort and the ER − cohort or ER + (≥10%) cohort. Eligible literature published from inception to November 20, 2016 was retrieved from the PubMed database on the basis of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data on survival outcomes were extracted and pooled odds ratios (ORs), 95% confidence intervals (CIs), and 2-tailed P values are reported. P values of the χ 2 test for comparison of clinicopathological characteristics among included patients in the ER + (1%-9%) cohort and the other 2 cohorts were calculated respectively. The analysis included 6 studies with 16,606 patients. Significant differences were detected between the ER + (1%-9%) cohort and the other 2 cohorts on the basis of clinicopathological characteristics respectively. When taking all of the patients into analysis without consideration of treatment modality, the ER + (1%-9%) cohort presented better prognosis than the ER − group in terms of 5-year disease-free survival (OR, 1.47; P =.046) and 5-year overall survival (OR, 1.23; P =.046). However, patients with ER + (1%-9%) breast cancer who received endocrine therapy seemed to have a prognosis similar to those without any endocrine therapy (P =.684) and those with ER − carcinoma who received endocrine therapy (P =.145). Patients with ER + (≥10%) tumors had better endocrine responsiveness compared with their ER + (1%-9%) counterparts (OR, 0.52; P =.034, ER + [1%-9%] vs. ER + [≥10%]). Our results indicate that primary breast cancer patients with ER + (1%-9%) expression gained no significant survival benefit from endocrine therapy, but manifested overall better prognosis than those with ER − cancer.
KW - Borderline estrogen receptor
KW - Breast carcinoma
KW - Endocrine treatment
KW - Immunohistochemical staining
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85023642263&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85023642263&partnerID=8YFLogxK
U2 - 10.1016/j.clbc.2017.06.005
DO - 10.1016/j.clbc.2017.06.005
M3 - Review article
C2 - 28712925
AN - SCOPUS:85023642263
SN - 1526-8209
VL - 18
SP - 1
EP - 8
JO - Clinical Breast Cancer
JF - Clinical Breast Cancer
IS - 1
ER -