The Value of Determination of Nuclear Oestrogen Receptors in Breast Cancer Biopsies

Abstract

The oestrogen receptor status of the soluble fraction of a tumour biopsy is now accepted as a valuable tool in the management of advanced breast cancer [11]. Soluble receptor status of primary disease may also be of value as a prognostic index [3, 20], although this value might be limited to patients with intermediate nodal involvement [19]. However, the presence of soluble receptors alone is not an absolute index of hormonal dependence [22]. Hormone-receptor complex might fail to undergo translocation/activation [37] or to bind to the correct acceptor sites on the DNA [33]. Loss of hormonal dependence through a breakdown at the post-transcriptional level is also a possibility. For these reasons several parameters of oestrogen response have been studied in breast tumour biopsies. Measurement of the presence of progesterone receptor (a product of oestrogen action) has proved productive [11]. The suggestion that a useful index of hormonal dependence might simply be the presence of nuclear-bound oestrogen receptor [21] has been followed up by several groups [2, 15, 29, 38].

Work from our own laboratory was supported, in part, by the Cancer Research Campaign, to whom we are very grateful. C. L. is pleased to acknowledge receipt of a Medical Research Council studentship. We are much indebted to our various surgical colleagues and, in particular, to David Smith and Ken Calman