Hormone receptor positive breast cancer has both estrogen receptor positive (ER+) and progesterone receptor positive (PR+) tumor receptor status. Compounds that regulate ER or PR expression, oppose the production of estrogen in the body (i.e., oppose aromatase) or inhibit estrogen binding to estrogen receptors are among those used to treat this type of breast cancer.
Hormone receptor positive tumors tend to metastasize first to the bone. Breast cancer patients with ER+/PR+ tumors have the most favorable prognosis compared to the other estrogen/progesterone subtypes (ER+/PR-, ER-/PR+, ER-/PR-).
However, large breast size is associated with reduced breast cancer survival in women with ER+ breast cancer, independent of body mass index (BMI). Because this is the most hormonally driven subtype, hormone receptor positive breast cancer survivors have the greatest opportunity to influence their prognosis through diet, exercise and other lifestyle choices that can influence estrogen and other hormone levels.

Hormone receptor positive breast cancer progression rates

In this section, we summarize available data published during the last three years concerning risk of recurrence for early-stage ER+/PR+ breast cancer. However, please note that outcomes can vary greatly depending on numerous factors, including those described above, as well as diet and other lifestyle choices. Also, the data below represents snapshots from studies that were conducted using different populations under a variety of circumstances. Therefore, the numbers are somewhat inconsistent and far from definitive and should not be used to calculate your likely recurrence-free survival. However, the data is useful in getting a general idea of hormone receptor positive breast cancer prognosis and to compare outcomes depending on treatment and other factors.

Patient and treatment characteristics → Likelihood of progression-free survival

Progression-free survival means that no recurrence, metastasis or breast cancer-related death took place during the specified period. Distant recurrence-free survival means there were no distant metastases and no breast cancer-related death occurred, however local recurrences (in the same breast, lymph nodes or chest wall) might have been found. Overall survival means no death occurred from any cause (including non-breast cancer-specific causes).
Overall survival after diagnosis of ER+ breast cancer
  • Five-year overall progression-free survival
    • ER+/PR+ Five-year progression-free survival → 90%
  • Twenty-year overall survival
    • ER+ Twenty-year overall survival → 78%
Degree of pathologic response after neoadjuvant chemotherapy
  • Survival based on residual tumor burden
    • ER+/PR+/HER2- Pathologic complete response or minimal residual cancer burden (RCB-I) after neoadjuvant treatment → 91% to 93% five-year progression-free survival
    • ER+/PR+/HER2- Moderate residual cancer burden (RCB-II) → 82% five-year progression-free survival
    • ER+/PR+/HER2- Extensive residual cancer burden (RCB-III) → 70% five-year progression-free survival
Breast cancer characteristics
  • Survival of stage II ER+/PR+ disease based on proliferation
    • ER+/PR+/HER2- Stage II, low Ki-67 (< 10%) → 84% five-year progression-free survival
    • ER+/PR+/HER2- Stage II, intermediate Ki-67 (10% to 19%) → 88% five-year progression-free survival
    • ER+/PR+/HER2- Stage II, high Ki-67 (≥ 20%) → 79% five-year progression-free survival
  • Survival based on lymph node status
    • ER+ Stage T1N0 (no positive lymph nodes), 5 years of aromatase inhibitor and/or tamoxifen → 87% distant recurrence-free survival through year 20
    • ER+ Stage T1N1-3 (1-3 positive lymph nodes), 5 years of aromatase inhibitor and/or tamoxifen → 80% distant recurrence-free survival through year 20
    • ER+ Stage T1N4-9, 5 years of aromatase inhibitor and/or tamoxifen → 80% distant recurrence-free survival through year 20
    • ER+ Stage T2N0, 5 years of aromatase inhibitor and/or tamoxifen → 81% distant recurrence-free survival through year 20
    • ER+ Stage T2N1-3, 5 years of aromatase inhibitor and/or tamoxifen → 74% distant recurrence-free survival through year 20
    • ER+ Stage T2N4-9, 5 years of aromatase inhibitor and/or tamoxifen → 59% distant recurrence-free survival through year 20
  • Survival based on grade
    • ER+ Stage T1N0, grade 1 (low grade disease), 5 years of aromatase inhibitor and/or tamoxifen → 90% distant recurrence-free survival through year 20
    • ER+ Stage T1N0, grade 2 (moderate grade), 5 years of aromatase inhibitor and/or tamoxifen → 87% distant recurrence-free survival through year 20
    • ER+ Stage T1N0, grade 3 (high grade), 5 years of aromatase inhibitor and/or tamoxifen → 83% distant recurrence-free survival through year 20
Extended aromatase inhibitor treatment
Note: Extended adjuvant therapy is recommended only for high-risk ER+ since increased arthralgia, myalgia, hot flushes and bone toxicity are linked to extended AI use.
  • Tamoxifen followed by Arimidex (anastrozole)
    • ER+ 2-3 years of tamoxifen followed by 3 years of Arimidex → 79% five-year progression-free survival
    • ER+ 2-3 years of tamoxifen followed by 6 years of Arimidex → 83% five-year progression-free survival
  • Arimidex (anastrozole) only
    • ER+ 5 years of Arimidex → 84% five-year progression-free survival
    • ER+ 10 years of Arimidex → 92% five-year progression-free survival
  • Endocrine treatment followed by Femara (letrozole)
    • ER+/PR+ Disease-free after 5 years of aromatase inhibitor and/or tamoxifen, no additional treatment → 81% seven-year progression-free survival
    • ER+/PR+ Disease-free after 5 years of aromatase inhibitor and/or tamoxifen, 5 additional years of Femara → 85% seven-year progression-free survival
Below are links to recent studies on this topic. For a more complete list of studies, please click on ER+/PR+. Please also see our articles on hormone receptor positive breast cancer (which describes ER+/PR+ disease) and what ER+/PR+ breast cancer patients and survivors should eat.