title: Response to primary chemotherapy in breast cancer patients with tumors not expressing estrogen and progesterone receptors.
abstract: BACKGROUND
  We recently demonstrated that in premenopausal patients with estrogen receptors (ER)-absent tumors, early initiation of systemic chemotherapy after primary surgery might improve outcome. These data indicate a different responsiveness to chemotherapy for tumors not expressing hormone receptors. To test this hypothesis we evaluated the responsiveness to preoperative chemotherapy in patients with ER and progesterone receptors (PgR)-absent tumors.
  
  
  METHODS
  Patients with biopsy-proven T2-T3, N0-2 breast cancer treated at a single institution from January 1995 to August 1999 with preoperative chemotherapy were retrospectively evaluated. ER and PgR were determined immunohistochemically and classified for this purpose as absent (0% of the cells positive) or positive (> or = 1% of the cells).
  
  
  RESULTS
  On 117 evaluable patients 72 had an objective response (61%). A significant difference in response was observed for patients with ER and PgR absent compared with those with ER and/or PgR-positive tumors (82% vs. 57%, P = 0.03 Fishers's exact test). Pathological complete remission rates were also significantly different in the two groups (23% vs. 7%, respectively; P = 0.04).
  
  
  CONCLUSIONS
  The different degree of response according to hormone receptors expression supports the hypothesis that tumors not expressing both ER and PgR might represent a different clinical entity in terms of chemotherapy responsiveness.
authors.affiliation: Division of Medical Oncology, Istituto Europeo di Oncologia, Milan, Italy. marco.colleoni@ieo.it
authors.forename: M
authors.initials: M
authors.lastname: Colleoni
authors.forename: I
authors.initials: I
authors.lastname: Minchella
authors.forename: G
authors.initials: G
authors.lastname: Mazzarol
authors.forename: F
authors.initials: F
authors.lastname: Nolè
authors.forename: G
authors.initials: G
authors.lastname: Peruzzotti
authors.forename: A
authors.initials: A
authors.lastname: Rocca
authors.forename: G
authors.initials: G
authors.lastname: Viale
authors.forename: L
authors.initials: L
authors.lastname: Orlando
authors.forename: G
authors.initials: G
authors.lastname: Ferretti
authors.forename: G
authors.initials: G
authors.lastname: Curigliano
authors.forename: P
authors.initials: P
authors.lastname: Veronesi
authors.forename: M
authors.initials: M
authors.lastname: Intra
authors.forename: A
authors.initials: A
authors.lastname: Goldhirsch
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017697:Premenopause; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis* / Q000096:biosynthesis; D011980:Receptors, Progesterone / Q000032:analysis* / Q000096:biosynthesis; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone