Estrogen Receptor-low Breast Cancer: Biology Chaos and Treatment Paradox

Overview

Journal Cancer Commun (Lond)

Publisher Wiley

Specialty Oncology

Date 2021 Jul 12

PMID 34251757

Citations 23

Authors

Ke-Da Yu

Yu-Wen Cai

Song-Yang Wu

Ruo-Hong Shui

Zhi-Ming Shao

Affiliations

Soon will be listed here.

Abstract

Hormone receptor testing mainly serves the purpose of guiding treatment choices for breast cancer patients. Patients with estrogen receptor (ER)-positive breast cancers show significant response to endocrine therapy. However, the methods to define ER status and eligibility for treatment remain controversial. Despite recent guidelines considering staining ≥1% of tumor nuclei by immunohistology as ER-positive, it has raised concerns on the benefit of endocrine therapy for tumors with ER 1%-10% expression, termed "ER-low positive". This subgroup accounts for 3% to 9% of all patients and is likely to have unique molecular features, and therefore distinct therapeutic response to endocrine therapy compared with ER-high positive tumors. The latest guidelines did not provide detailed descriptions for those patients, resulting in inconsistent treatment strategies. Consequently, we aimed to resolve this dilemma comprehensively. This review discusses molecular traits and recent ER-low positive breast cancer innovations, highlighting molecular-targeted treatment rather than traditional unified endocrine therapy for future basic and clinical research.

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