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Oestrogen receptors and breast cancer: are we prepared to move forward? A critical review

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Abstract

It is nearly 60 years since the identification of the oestrogen hormone receptor (ER) in breast cancer, a discovery that radically transformed the clinical management of the disease. Hormonal therapy with anti-oestrogens (Tamoxifen and Aromatase inhibitors) antagonises ER function and became the mainstay treatment until today. Around 70% of breast tumours are classified as oestrogen dependent, yet the mechanism of action of other hormones in breast cancer growth both independently and interacting with ER as well as their targeted therapies have yet to find a place in the clinic. In this article, I critically review the scientific literature for the period 1960–2016 and examine the rise and persistence of the oestrogen hypothesis as well as the neglect of alternative hormonal explanations. By using Pierre Bourdieu’s concepts of the scientific field alongside feminist science scholars to explore the impact of gendered assumptions on science, the analysis provides insight into the dominant role of the oestrogen hypothesis and the struggles for legitimation of different alternative perspectives. I consider these alternative approaches as “internal” struggles for scientific authority, which are in turn, socially determined by “external” gender values that reinforce a binary arrangement of male/female bodies based on fixed molecular hormonal traits.

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Notes

  1. On oestrogen action: Allen and Doisy 1923 administered oestrogens to ovariectomised rats obtaining the cornification of the vagina, whilst Lacassagne 1932 observed that oestrogen injections increased the incidence of breast cancer in female and male mice.

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Acknowledgements

I would like to thank the comments of colleagues and participants of the Remaking Cancer Network at the University of Manchester and the Institute of Humanities at the National University of Córdoba where versions of this paper were discussed. I extend my sincere gratitude and thanks to the anonymous reviewers who generously provided feedback. I also acknowledge the support of London Metropolitan University who provided financial support for the research discussed in the article.

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    Yolanda Eraso

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Eraso, Y. Oestrogen receptors and breast cancer: are we prepared to move forward? A critical review. BioSocieties 15, 627–649 (2020). https://doi.org/10.1057/s41292-019-00173-5

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