ER-/PR+ breast cancer characteristics

Last updated: March 6, 2024

Characteristics of ER-/PR+ breast cancer

Invasive breast cancers classified as estrogen receptor negative and progesterone receptor positive (ER-/PR+/HER2+ or ER-/PR+/HER2-) are relatively rare, accounting for less than 1% of U.S. breast cancer cases. In ER-/PR+ tumors, the cancer cells express progesterone receptors, but not estrogen receptors.

Women with ER-/PR+ breast cancer are more likely to be premenopausal. Women with high breast density have an increased risk of breast cancer, including ER-/PR+ tumors. One study reported that percent mammographic density appears to be inversely associated with ER expression but might correlate positively with PR expression.

While in some respects very similar to ER-/PR- disease, women with ER-/PR+ tumors have a somewhat better prognosis. Endocrine treatments such as tamoxifen that are effective for hormone receptor positive breast cancer are less successful in treating this type of cancer, although they are used.

Because ER-/PR+ tumors are rare, very few studies have specifically investigated this subtype. Please see our article on diet for ER-/PR+ breast cancer patients and survivors for available research pertaining to diet and supplements.

Below are links to 20 studies concerning this topic.

Selected breast cancer studies

Clinical Outcomes and Intrinsic Subtypes of Breast Cancer Patients with Single Hormone Receptor-positive Receiving Neoadjuvant Chemotherapy Cite
Wang T, Wang J, Zhao W, Pan Y. Clinical Outcomes and Intrinsic Subtypes of Breast Cancer Patients with Single Hormone Receptor-positive Receiving Neoadjuvant Chemotherapy. Clinical Breast Cancer. Elsevier BV; 2024; 10.1016/j.clbc.2024.02.016
Breast Cancer Incidence Among US Women Aged 20 to 49 Years by Race, Stage, and Hormone Receptor Status Cite
Xu S, Murtagh S, Han Y, Wan F, Toriola AT. Breast Cancer Incidence Among US Women Aged 20 to 49 Years by Race, Stage, and Hormone Receptor Status. JAMA Network Open. American Medical Association (AMA); 2024; 7:e2353331 10.1001/jamanetworkopen.2023.53331
Trends in the Incidence and Survival of Women with Hormone Receptor-Positive Breast Cancer from 1990–2019: A Large Population-Based Analysis Cite
Huang Hb, Wei T, Zhang A, Zhang H, Kong L, Li Y, et al. Trends in the Incidence and Survival of Women with Hormone Receptor-Positive Breast Cancer from 1990–2019: A Large Population-Based Analysis. Research Square Platform LLC; 2023; 10.21203/rs.3.rs-3569419/v1
Impact of estrogen receptor expression level on response to neoadjuvant chemotherapy and prognosis in HER2-negative breast cancers Cite
Chen H, Huang F, Chen Q, Deng Y. Impact of estrogen receptor expression level on response to neoadjuvant chemotherapy and prognosis in HER2-negative breast cancers. BMC Cancer. Springer Science and Business Media LLC; 2023; 23 10.1186/s12885-023-11368-2
Quantifying hormone receptor status in lobular breast cancer in an institutional series: the relationship between estrogen and progesterone receptor status and outcomes Cite
Clelland EN, Rothschild HT, Patterson A, Molina-Vega J, Kaur M, Symmans WF, et al. Quantifying hormone receptor status in lobular breast cancer in an institutional series: the relationship between estrogen and progesterone receptor status and outcomes. Breast Cancer Research and Treatment. Springer Science and Business Media LLC; 2023; 10.1007/s10549-023-07059-y
THE CLINICAL AND BIOLOGICAL SIGNIFICANCE OF ESTROGEN RECEPTOR-LOW POSITIVE BREAST CANCER Cite
Makhlouf S, Althobiti M, Toss M, Muftah AA, Mongan NP, Lee AH, et al. THE CLINICAL AND BIOLOGICAL SIGNIFICANCE OF ESTROGEN RECEPTOR-LOW POSITIVE BREAST CANCER. Modern Pathology. Elsevier BV; 2023;:100284 10.1016/j.modpat.2023.100284
ER–/PR+ breast cancer is controlled more effectively with an inflammatory inhibitor than hormonal inhibitor Cite
Song C, Kendi AT, Shim JY, Jung D, Kang PS, Lowe VJ, et al. ER–/PR+ breast cancer is controlled more effectively with an inflammatory inhibitor than hormonal inhibitor. Breast Cancer. Springer Science and Business Media LLC; 2023; 10.1007/s12282-023-01437-6
Definition of High-Risk Early Hormone-Positive HER2−Negative Breast Cancer: A Consensus Review Cite
Garutti M, Griguolo G, Botticelli A, Buzzatti G, De Angelis C, Gerratana L, et al. Definition of High-Risk Early Hormone-Positive HER2−Negative Breast Cancer: A Consensus Review. Cancers. MDPI AG; 2022; 14:1898 10.3390/cancers14081898
Estrogen receptor status heterogeneity in breast cancer tumor: role in response to endocrine treatment Cite
Malavasi E, Giamas G, Gagliano T. Estrogen receptor status heterogeneity in breast cancer tumor: role in response to endocrine treatment. Cancer Gene Therapy. Springer Science and Business Media LLC; 2023; 10.1038/s41417-023-00618-x
The Prognosis and Predictive Value of Estrogen Negative/Progesterone Positive (ER−/PR+) Phenotype: Experience of 1159 Primary Breast Cancer from a Single Institute Cite
Gamrani S, Boukansa S, Benbrahim Z, Mellas N, Fdili Alaoui F, Melhouf MA, et al. The Prognosis and Predictive Value of Estrogen Negative/Progesterone Positive (ER−/PR+) Phenotype: Experience of 1159 Primary Breast Cancer from a Single Institute. The Breast Journal. Hindawi Limited; 2022; 2022:1-9 10.1155/2022/9238804
De‐escalation of five‐year adjuvant endocrine therapy in patients with estrogen receptor‐low positive (immunohistochemistry staining 1%‐10%) breast cancer: Propensity‐matched analysis from a prospectively maintained cohort Cite
Cai Y, Shao Z, Yu K. De‐escalation of five‐year adjuvant endocrine therapy in patients with estrogen receptor‐low positive (immunohistochemistry staining 1%‐10%) breast cancer: Propensity‐matched analysis from a prospectively maintained cohort. Cancer. Wiley; 2022; 10.1002/cncr.34155
High expression of progesterone receptor may be an adverse prognostic factor in oestrogen receptor-negative/progesterone receptor-positive breast cancer: results of comprehensive re-evaluation of multi-institutional case series Cite
Kunc M, Pęksa R, Cserni G, Iżycka-Świeszewska E, Łacko A, Radecka B, et al. High expression of progesterone receptor may be an adverse prognostic factor in oestrogen receptor-negative/progesterone receptor-positive breast cancer: results of comprehensive re-evaluation of multi-institutional case series. Pathology. Elsevier BV; 2022; 10.1016/j.pathol.2021.10.003
Prevalence, treatment patterns, and prognosis of low estrogen receptor-positive (1% to 10%) breast cancer: a single institution’s experience in Korea Cite
Park YH, Karantza V, Calhoun SR, Park S, Lee S, Kim J, et al. Prevalence, treatment patterns, and prognosis of low estrogen receptor-positive (1% to 10%) breast cancer: a single institution’s experience in Korea. Breast Cancer Research and Treatment. Springer Science and Business Media LLC; 2021; 10.1007/s10549-021-06309-1
Characterization of estrogen receptor-low-positive breast cancer Cite
Fei F, Siegal GP, Wei S. Characterization of estrogen receptor-low-positive breast cancer. Breast Cancer Research and Treatment. Springer Science and Business Media LLC; 2021; 10.1007/s10549-021-06148-0
ER‐/PR+ breast cancer: a distinct entity, which is morphologically and molecularly close to triple‐negative breast cancer Cite
Beltjens F, Molly D, Bertaut A, Richard C, Desmoulins I, Loustalot C, et al. ER‐/PR+ breast cancer: a distinct entity, which is morphologically and molecularly close to triple‐negative breast cancer. International Journal of Cancer. Wiley; 2021; 10.1002/ijc.33539
Clinical Features and Survival of Single Hormone Receptor–Positive Breast Cancer: A Population-Based Study of 531,605 Patients Cite
Lv M, Mao Y, Song Y, Wang Y, Liu X, Wang X, et al. Clinical Features and Survival of Single Hormone Receptor–Positive Breast Cancer: A Population-Based Study of 531,605 Patients. Clinical Breast Cancer. Elsevier BV; 2020; 20:e589-e599 10.1016/j.clbc.2020.04.010
Single Hormone Receptor-Positive Breast Cancers Have Distinct Characteristics and Survival Cite
Dauphine C, Moazzez A, Neal JC, Chlebowski RT, Ozao-Choy J. Single Hormone Receptor-Positive Breast Cancers Have Distinct Characteristics and Survival. Annals of Surgical Oncology. Springer Science and Business Media LLC; 2020; 27:4687-4694 10.1245/s10434-020-08898-5
The significance of highlighting the oestrogen receptor low category in breast cancer Cite
Poon IK, Tsang JY, Li J, Chan S, Shea K, Tse GM. The significance of highlighting the oestrogen receptor low category in breast cancer. British Journal of Cancer. Springer Science and Business Media LLC; 2020; 123:1223-1227 10.1038/s41416-020-1009-1
Clinicopathological Characteristics and Breast Cancer–Specific Survival of Patients With Single Hormone Receptor–Positive Breast Cancer Cite
Li Y, Yang D, Yin X, Zhang X, Huang J, Wu Y, et al. Clinicopathological Characteristics and Breast Cancer–Specific Survival of Patients With Single Hormone Receptor–Positive Breast Cancer. JAMA Network Open. American Medical Association (AMA); 2020; 3:e1918160 10.1001/jamanetworkopen.2019.18160
ER−/PR+/HER2− breast cancer type shows the highest proliferative activity among all other combined phenotypes and is more common in young patients: Experience with 6643 breast cancer cases Cite
Arena V, Pennacchia I, Vecchio FM, Carbone A. ER−/PR+/HER2− breast cancer type shows the highest proliferative activity among all other combined phenotypes and is more common in young patients: Experience with 6643 breast cancer cases. The Breast Journal. Wiley; 2019; 25:381-385 10.1111/tbj.13236

Selected breast cancer studies

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