Originally published as JCO Early Release 10.1200/JCO.2005.04.076 on April 18 2005

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Hormone Receptor Status of a Contralateral Breast Cancer Is Independent of the Receptor Status of the First Primary in Patients Not Receiving Adjuvant Tamoxifen

From the Breast Center, Baylor College of Medicine and The Methodist Hospital, Houston, TX

Address reprint requests to C. Kent Osborne, MD, Breast Center, Baylor College of Medicine, One Baylor Plaza, BCM 600, Houston, TX 77030; e-mail: kosborne{at}breastcenter.tmc.edu

PURPOSE: To determine whether the hormone receptor status of the primary breast cancer (PBC) is predictive of the hormone receptor status of the subsequent contralateral breast cancer (CBC).

PATIENTS AND METHODS: We identified patients in our database with known estrogen receptor (ER; n = 193) and/or progesterone receptor (PgR; n = 178) status in their PBC and in their subsequent CBC. One hundred twenty-six of these patients had received no adjuvant therapy, 34 had received adjuvant tamoxifen, and 33 had received adjuvant chemotherapy alone. The median interval between the first diagnosis of PBC and the development of the subsequent CBC was 3 years. ER and PgR assays were assessed biochemically in two central reference laboratories using identical quality-controlled ligand-binding methods.

RESULTS: Among systemically untreated patients (n = 126), 88% of patients with ER-positive PBC and 75% of patients with ER-negative PBC developed an ER-positive CBC (P = .11). Among the tamoxifen-treated patients, those with an ER-positive PBC were almost equally likely to develop an ER-positive (47%) or ER-negative (53%) CBC (P = .99). PgR status was similar. In the untreated group (n = 112), 59% of patients with a PgR-positive PBC and 66% with a PgR-negative PBC developed a PgR-positive CBC (P = .48). Among tamoxifen-treated patients (n = 33), 50% of patients with a PgR-positive PBC versus 27% of patients with a PgR-negative PBC developed a PgR-positive CBC (P = .28).

CONCLUSION: ER and PgR status of the primary tumor does not predict the hormone receptor status of the subsequent CBC in the absence of selective pressure of adjuvant therapy. Thus, other reasons should be considered to clarify the failure of tamoxifen to reduce the incidence of CBC in patients with a receptor-negative PBC.

Supported by grant Nos. P01 CA30195 and P50 CA58183 (SPORE) from the National Institutes of Health (Bethesda, MD) and Association Italian of Medical Oncology.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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• Contralateral Breast Cancer: Where Does It All Begin?
  Suparna Bonthala Wedam and Sandra M. Swain
  JCO 2005 23: 4585-4587 [Full Text]

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