Clinical Studies on Hormonal Status in Breast Cancer and its Impact on Quality of Life(QOL)

Abstract

Breast cancer is a steroid hormone–dependent tumor. Stratification of patients according to hormone (ER/ PR) receptor status and nodal metastasis is of great therapeutic importance. In this investigation, we could enroll 79 pre and post-menopausal breast cancer patients voluntarily. We classified these cases into four categories of the combinations of ER/PR positive, negative and mixed statuses. Their hormone receptor status as determined by immunohistochemistry correlated with therapy regimens like chemotherapy, hormone therapy and QOL responses. We found that in ER+/PR- and ER-/PR- tumors were more frequent in postmenopausal women than ER+/PR+ tumors. The ER+/PR- tumors were larger than ER+/PR+ tumors. In addition, 21.51% of ER+/PR- and 17.72% of ER-/PR- patients had four or more axillary nodes involved with tumors compared to patients with ER+/PR+ tumors (7.59%). Postmenopausal women with ER+/PR- and ER-/PR- who received adjuvant hormonal therapy or combination of chemo drugs like Cyclophosphamide, Adriamycin, 5-FU (FAC) and Cyclophosphamide, Alurubicin, 5-FU (CAF) showed good response than premenopausal women. Forty patients receiving tamoxifen (hormone therapy) along with other chemo- drugs also showed good response. Tamoxifen induced substantial tumor regression and increased disease free survival. It is concluded that hormone receptor status is important in deciding the choice of treatment for all subgroups and influenced the QOL. Another significant observation was that the frequency of ER+/PR- and ER-/PR- tumors was higher in this study group compared to ER+/PR+ tumors. This is the first report from south Indian population indicating the importance of hormonal status in deciding therapeutic regimens in breast cancer patients affecting their QOL.