title: Estrogen receptor expression in atypical hyperplasia: lack of association with breast cancer.
abstract: Estrogen receptor (ER) is expressed in normal and malignant breast epithelium, and expression levels have been found to increase with age in normal breast epithelium but not in atypical hyperplasia (AH) and carcinoma in situ. Here we assess ER expression in AH and its association with later breast cancer. ER expression was assessed immunohistochemically in archival sections from 246 women with AH who had open benign breast biopsy from 1967 to 1991. The ACIS III (Dako) was utilized to calculate ER expression in all atypical foci. Using multivariate linear regression, we examined associations of ER expression with age at biopsy, indication for biopsy, type of atypia, number of atypical foci, involution status, and family history. Breast cancer risk across levels of ER expression was also assessed compared with the Iowa SEER control population. Among 246 women, 87 (35%) had atypical ductal hyperplasia (ADH), 141 (57%) had atypical lobular hyperplasia (ALH), and 18 (7%) had both. Forty-nine (20%) developed breast cancer (median follow-up of 14.4 years). Multivariate analysis indicated that type of atypia and age at diagnosis were significantly associated with ER percent staining and intensity (P < 0.05). ER expression was increased in women with ADH and/or those over age 55. ER expression did not significantly impact breast cancer risk in patients diagnosed with atypia. We found increasing ER expression in AH with increasing age. ER expression in AH does not further discriminate breast cancer risk in women with atypia.
authors.affiliation: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Fritcher Emily G
authors.initials: FE
authors.lastname: Barr
authors.forename: Amy C
authors.initials: AC
authors.lastname: Degnim
authors.forename: Lynn C
authors.initials: LC
authors.lastname: Hartmann
authors.forename: Derek C
authors.initials: DC
authors.lastname: Radisky
authors.forename: Judy C
authors.initials: JC
authors.lastname: Boughey
authors.forename: Stephanie S
authors.initials: SS
authors.lastname: Anderson
authors.forename: Robert A
authors.initials: RA
authors.lastname: Vierkant
authors.forename: Marlene H
authors.initials: MH
authors.lastname: Frost
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Visscher
authors.forename: Carol
authors.initials: C
authors.lastname: Reynolds
mesh_terms: D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D006965:Hyperplasia / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D011960:Receptors, Estrogen / Q000096:biosynthesis*; D018426:SEER Program; D016896:Treatment Outcome
chemical_list: D011960:Receptors, Estrogen