Document Type : Original Research


Dept. of Pathology, University of Health Sciences, Rohtak, Haryana, India



Background and Objective: Breast cancer is the commonest cancer of Indian women. Estrogen and Progesterone expression is seen in benign breast lesions and in breast carcinoma associated with good prognostic parameters and it correlates well with response to hormone therapy. Although a lot of studies have been conducted in the past on hormone receptor expression in breast cancer and few have correlated them with other prognostic parameters of breast cancer, the present study was intended to document the prevalence of hormone receptor positive breast carcinomas in our population; their importance in benign breast diseases; to document a reliable scoring system of hormone receptors expression by Quick scoring; to correlate them with most of the proven prognostic parameters of breast carcinoma. Methods: Tissue specimens from 25 patients with benign breast disease and 50 patients with breast carcinoma were assayed for estrogen (ER) and progesterone (PR) receptors using Quick scoring. ER/PR expression in breast carcinomas was correlated with various prognostic parameters including patients’ age, menopausal status, tumor size, type, MBR grade, NPI, lymphatic vessel invasion, lymph node stage, lymphomononuclear invasion, elastosis and HER2/neu status.  Result: Scoring of steroid receptors paralleled intensity of hyperplasia in benign breast diseases but in breast carcinoma, it was inversely correlated with grade of tumor, NPI, HER2/neu status, tumor necrosis, lymphomononuclear infiltrate and elastosis. We found no relationship with tumor size, lymph node status or age.  Conclusion: Assessment of hormone receptors for clinical management of breast cancer patients is strongly advocated to provide prognostic information and best therapeutic options  


  1. Agarwal G, Ramakant P. Breast cancer care in India: The current scenario and the challenges for the future. Breast Care 2008;3:21-7.
  2. Rosai J. Rosai and Ackerman’s Surgical Pathology. 9th ed. Missouri: Mosby; 2004.
  3. Jensen EV. Hormone dependency of breast cancer. Cancer 1981;47(10):2319-26.
  4. Jacquemier JDRolland PHVague DLieutaud RSpitalier JMMartin PM. Relationships between steroid receptor and epithelial cell proliferation in benign fibrocystic disease of the breast. Cancer 1982;49(12):2534-6.
  5. Giani CD'Amore EDelarue JC,  Mouriesse H, May-Levin F, Sancho-Garnier H, et al. Estrogen and progesterone receptors in benign breast tumor s and lesions: relationship with histological and cytological features.  Int J Cancer 1986;37(1):7-10.
  6. Umekita YYoshida H. Immunohistochemical study of hormone receptor and hormone-regulated protein expression in phyllodes tumor: comparison with fibroadenoma. Virchows Arch 1998 ;433(4):311-4.
  7. Fletcher CDM. Diagnostic Histopathology of Tumors. 3rd ed. Philadelphia: Churchill Livingstone; 2007.
  8. Henson DEFielding LPGrignon DJ,  Page DL, Hammond ME, Nash G, et al. College of American Pathologists Conference XXVI on clinical relevance of prognostic markers in solid tumor s. Summary. Members of the Cancer Committee. Arch Pathol Lab Med 1995;119(12):1109-12.
  9. Leake R, Barnes D, Pinder S, Ellis I, Anderson L, Anderson T, et al. Immunohistochemical detection of steroid receptors in breast cancer: A working protocol. J Clin Pathol 2000;53:634-5.
  10. Silverberg SG, DeLellis RA, Frable WJ, Livolsi VA, Wick MR. Silverberg’s Principles and Practice of Surgical Cytopathology. 4th ed. Philadelphia: Churchill Livingstone; 2006.
  11. Bancroft JD, Gamble M. Theory and Practice of Histologic techniques. 6th ed. Philadelphia: Churchill Livingstone; 2008.
  12. Mudduwa LK. Quick score of hormone receptor status of breast carcinoma: correlation with other clinicopathological prognostic parameters. Indian J Pathol Microbiol 2009;52:159-63.
  13. Mohammed RHLakatua DJHaus EYasmineh WJ. Estrogen and progesterone receptors in human breast cancer. Correlation with histologic subtype and degree of differentiation.Cancer 1986;58(5):1076-81.
  14. Sughayer MH, Al-Khawaja M, Massarweh S, Al-Masri M. Prevalence of hormone receptors and HER2/neu in breast cancer cases in Jordan. Pathol Oncol Res 2006;12:83-6.
  15. Desai SB, Moonim MT, Gill AK, Punia RS, Naresh KN, Chinoy RF. Hormone receptor status of breast cancer in India: A study of 798 tumor s. Breast 2000;9:267-70.
  16. Fisher ER, Redmond CK, Liu H, Rockette H, Fisher B. Correlation of estrogen receptor and pathologic characteristics of invasive breast cancer. Cancer 1980;45:349-53.
  17. Huang WY, Newman B, Millikan RC, Schell MJ, Hulka BS, Moorman PG. Hormone – related factors and risk of breast cancer in relation to estrogen receptor and progesterone receptor status. Am J Epidemiol 2000;151(7):703-14.
  18. Fatima S, Faridi N, Gill S. Breast cancer: steroid receptors and other prognostic indicators. J Coll Physicians Surg Pak 2005;15(4):230-3.
  19. Rosenberg LU, Einarsdo´ ttir K, Friman EI, Wedren S, Dickman PW, Hall P, et al. Risk factors for hormone receptor-defined breast cancer in postmenopausal women. Cancer Epidemiol Biomarkers Prev 2006;15(12):2482-8.
  20. Dunnwald LK, Rossing MA, Li CI. Hormone receptor status, tumor  characteristics, and prognosis: a prospective cohort of breast cancer patients.Breast Cancer Res 2007;9(1):1-10.
  21. Azizun-Nisa, Bhurgri Y, Raza F, Kayani N. Comparison of ER, PR and HER-2/neu (C-erb B 2) reactivity pattern with histologic grade, tumor  size and lymph node status in breast cancer. Asian Pac J Cancer Prev 2008;9(4):553-6.
  22. Pichon MF, Broet P, Magdelenat H, Delarue JC, Spyratos F, Basuyau JP, et al. Prognostic value of steroid receptors after long-term follow-up of 2257 operable breast cancers. Br J Cancer 1996;73:1545-51.
  23. Enger SM, Ross RK, Paganini-Hill A, Longnecker MP, Bernstein L. Alcohol consumption and breast cancer oestrogen and progesterone receptor status. Br J Cancer 1999;79(7/8):1308-14.
  24. Contesso GDelarue JCMouriesse HMay-Levin FGarnier H. Anatomopathology of breast cancer and hormone receptors. Pathol Biol 1983;31(9):747-54.
  25. Thike AA, Chng MJ, Fook-Chong S, Tan PH. Immunohistochemical expression of hormone receptors in invasive breast carcinoma: correlation of results of H-score with pathological parameters. Pathology 2001;33(1):21-5.
  26. Ayadi A, Khabir A, Amouri H, Karray S, Dammak A, Guermazi M, et al. Correlation of HER-2 over-expression with clinico-pathological parameters in Tunisian breast carcinoma. World J Surg Oncol 2008;6:112.
  27. Mudduwa LK. Quick score of hormone receptor status of breast carcinoma: correlation with other clinicopathological prognostic parameters. Indian J Pathol Microbiol 2009;52:159-63.
  28. Barnes NLP, Boland GP, Davenport A, Knox WF, Bundred NJ. Relationship between hormone receptor status and tumor  size, grade and comedo necrosis in ductal carcinoma in situ. Br J Surg 2005;92:429-34.
  29. Millis RR. Correlation of hormone receptors with pathological features in human breast cancer. Cancer 1980;46:2869-71.
  30. Fisher ER, Osborne CK, McGuire WL, Redmond C, Knight WA 3rd, Fisher B, et al. Correlation of primary breast cancer histopathology and estrogen receptor content. Breast Cancer Res Treat 1981;1:37-41.
  31. Howat JM, Barnes DM, Harris M, Swindell R. The association of cytosol estrogen and progesterone receptors with histologic features of breast cancer and early recurrence of disease. Br J Cancer 1983;47:629-40.
  32. Schmitt FC, Andrade LM, de Lucca LA. Detection of estrogen receptor in formalin fixed and paraffin embedded breast carcinoma: correlation with histologic patterns. Rev Paul Med 1992;110:158-62.
  33. Rolland PH, Jacquemier J, Martin PM. Histological differentiation in human breast cancer is related to steroid receptors and stromal elastosis. Cancer Chemother Pharmacol 1980;5(2):73-7.
  34. Lima-de-Almeida FM, Brentani MM, Velludo MA, Goes JC, Baruffi I. Elastosis and steroid receptors in primary breast cancer. Braz J Med Biol Res 1985;18(3):279-83.
  35. Sasaki YTsuda H. Clinicopathological characteristics of triple-negative breast cancers. Breast Cancer 2009;16(4):254-9.
  36. Onitilo AA, Engel JM, Greenlee RT, Mukesh BN. Breast cancer subtypes based on ER/PR and HER2/neu expression: Comparison of clinicopathologic features and survival. Clin Med Res 2009;7(1-2):4-13.
  37. Iwase HKurebayashi JTsuda H, Ohta T, Kurosumi M, Miyamoto K, et al. Clinicopathological analyses of triple negative breast cancer using surveillance data from the Registration Committee of the Japanese Breast Cancer Society. Breast Cancer 2010;17(2):118-24.
  38. Chacón RCostanzo M. Triple-negative breast cancer. Breast Cancer Res 2010;12 Suppl 2:S3.
  39. Bauer K, Parise C, Caggiano V. Use of ER/PR/HER2 subtypes in conjunction with the 2007 St Gallen Consensus Statement for early breast cancer. BMC Cancer 2010;10:228.