title: [Lack of progesterone receptor expression predicts poor prognosis in patients with operable ER-positive invasive breast cancer].
abstract: OBJECTIVE
  To investigate the impact of lack of progesterone receptor (PR) expression on the prognosis of patients with operable ER (estrogen receptor)-positive invasive breast cancer.
  
  
  METHODS
  We retrospectively analyzed the clinicopathological features, treatment and survival data of 318 women with ER+ /PR+ and ER+ /PR- invasive breast cancer.
  
  
  RESULTS
  Among the 318 patients, there were 219 PR-positive and 99 PR-negative cases. The 5-year overall survival (OS) rate was 92.5%, and the 5-year disease-free survival (DFS) rate was 87.2% in the 318 ER-positive patients. Among them, the 5-year OS rates were significantly different between the PR-positive group (94.6%) and PR-negative group (87.8%, P=0.020), and the 5-year DFS rates were also significantly different from each other (89.8% and 81.6%, respectively, P=0.019). Univariate analysis showed that PR status, tumor size, T stage, axillary lymph node metastasis, and clinical stage were prognostic factors for OS (P<0.05 for all). Multivariate analysis showed that lack of PR expression, T stage ≥2, and positive axillary lymph node metastasis were independent risk factors for poor DFS and OS in ER-positive breast cancer patients (P<0.05 for all). Subgroup analysis showed that lack of PR expression was not significant in predicting poor DFS or OS when patients were in stage Ⅰ or with a small tumor (≤2 cm) (P>0.05 for all), and also showed that premenopausal women with PR-negative disease had poorer DFS and OS than PR-positive patients (P<0.05 for both).
  
  
  CONCLUSIONS
  Lack of PR expression is an independent risk factor for poor prognosis in patients with operable ER-positive invasive breast cancer, especially in patients with a large tumor (>2 cm), advanced clinical stage (Stage Ⅱ or Ⅲ) or in premenopausal status.
authors.affiliation: Department of Breast Surgery, the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: R M
authors.initials: RM
authors.lastname: Ma
authors.affiliation: Department of Surgical Oncology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: C Z
authors.initials: CZ
authors.lastname: Chen
authors.affiliation: Department of Surgical Oncology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: C Q
authors.initials: CQ
authors.lastname: Lin
authors.affiliation: Department of Surgical Oncology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: W
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Surgical Oncology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: G L
authors.initials: GL
authors.lastname: Guo
mesh_terms: D001943:Breast Neoplasms; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D011374:Progesterone; D011379:Prognosis; D011980:Receptors, Progesterone; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D011980:Receptors, Progesterone; D011374:Progesterone