Borderline ER-Positive Primary Breast Cancer Gains No Significant Survival Benefit From Endocrine Therapy: A Systematic Review and Meta-Analysis

Tong Chen, Ning Zhang, Meena S. Moran, Peng Su, Bruce Haffty, Qifeng Yang

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalClinical Breast Cancer
Issue number1
StatePublished - Feb 2018

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


  • Borderline estrogen receptor
  • Breast carcinoma
  • Endocrine treatment
  • Immunohistochemical staining
  • Prognosis

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