Role Of Receptors In The Management Of Patients With Breast-Cancer

The role of prognostic markers in the selection of therapy for patients with invasive breast cancer is reviewed with particular reference to steroid and growth factor receptors. Up to one third of the patients with negative axillary nodes at the time of diagnosis will die by 10 years, so the selection of high-risk, node-negative patients for adjuvant therapy is an important aim. Steroid receptor analysis gives useful information about overall prognosis, but may have a greater role in selecting patients for endocrine therapy following relapse. A number of growth factor receptors have been demonstrated on breast cancer cells. The epidermal growth factor receptor is overexpressed in about one third of operable breast cancers, and this is associated with a poor prognosis. Overexpression of the epidermal growth factor receptor in otherwise good prognostic subgroups, such as axillary node negative, low and intermediate histological grade tumours, appears to identify high-risk patients. The product of the c-erb-B2 oncogene is another growth factor receptor and is overexpressed in just under one fifth of invasive breast cancers. It too appears to be a poor prognostic marker and may complement epidermal growth factor receptor data.