Estrogen receptor‐low breast cancer: Biology chaos and treatment paradox. Issue 10 (12th July 2021)

• Record Type: Journal Article
• Authors: Yu, Ke‐Da; Cai, Yu‐Wen; Wu, Song‐Yang; Shui, Ruo‐Hong; Shao, Zhi‐Ming
• Is Part Of: Cancer communications. Volume 41:Issue 10(2021)
• Page Start: 968
• Page End: 980
• Publication Date: 2021-07-12
• Subjects: breast cancer -- immunohistochemistry -- estrogen receptor‐low -- endocrine therapy -- intrinsic subtype; Cancer -- Periodicals; Neoplasms; Electronic journals; Periodical; Fulltext; Internet Resources; Periodicals; Periodicals; 616.994005
• DOI: 10.1002/cac2.12191
• Languages: English
• ISSNs: 2523-3548

Abstract

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. Abstract : 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.