The Who, What, Where, When and Sometimes, Why.

Estrogen receptor status and overall survival

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s important to understand some key concepts. Learn how to read a research table.

Introduction: Estrogen receptor status helps guide breast cancer treatment.

  • Estrogen receptor-positive (ER-positive) tumors express estrogen receptors. This means they have a lot of estrogen receptors.
  • Estrogen receptor-negative (ER-negative) tumors do not express estrogen receptors. This means they have few or no estrogen receptors.

ER-positive breast cancers can be treated with hormone therapies such as tamoxifenaromatase inhibitors and ovarian suppression.

Prognosis

People with ER-positive breast cancers tend to have better survival than people with ER-negative breast cancers.

As the studies below show, 5-year survival after diagnosis is about 10 percent better for women with ER-positive breast cancer than for those with ER-negative tumors.

After about 5 years, this survival difference begins to decrease and over time, goes away [1-2].

Learn about the strengths and weaknesses of different types of studies.  

Study selection criteria: Prospective cohort studies with at least 1,500 participants and at least 5 years of follow-up.

 

Study

Study Population
(number of participants)

Characteristics of Breast Cancer

Follow-up
(years)

 5-Year Overall Survival  

ER-Positive

ER-Negative

Prospective cohort studies

SEER [4]

111,993

Stage I, II or III*

8

Women younger than 40:
90%†Sig

Women 40-49:
94%†Sig

Women 50-59:
95%†Sig

Women 60-69:
95%†Sig

Women 70-74:
94%†Sig

Women younger than 40:
78%†Sig  

Women 40-49:
81%†Sig  

Women 50-59:
81%†Sig

Women 60-79:
81%†Sig

Women 70-74:
80%†Sig

Danish Breast Cancer Cooperative Group [2]

26,944

Grade I, II or III

5

85%‡

69%‡

Truong et al. [5]

8,038

T1-2

Grade I, II or III

4-6

Higher
survival
Sig

Lower
survival
Sig

Sopik et al. [6]

1,910

Stage I, II or II*

15

95%†,§

80%†,§

Jayasekara et al. [7]

1,196

Stage I, II or III*

15

89%¶

78%¶

Sig = Statistically significant difference in survival
NS = No statistically significant difference in survival

cm = centimeter

Breast cancer stage as classified before 2018.

† Rates are for breast cancer survival (death from breast cancer), not overall survival (death from any cause).

‡ For the 3,591 women for whom 10-year survival data were available, 10-year survival was 68% for those with ER-positive tumors and 57% for those with ER-negative tumors.

§ Rates are estimated from a figure. Breast cancer survival at 15 years was 77% for women with ER-positive tumors and 70% for women with ER-negative tumors.

¶ Overall survival at 10 years was 77% for women with ER-positive tumors and 68% for women with ER-negative tumors.

References

  1. Fisher B, Redmond C, Fisher ER, Caplan R. Relative worth of estrogen or progesterone receptor and pathologic characteristics of differentiation as indicators of prognosis in node-negative breast cancer patients: Findings from National Surgical Adjuvant Breast and Bowel Project Protocol B-06. J Clin Oncol. 6(7):1076-87, 1988.
  2. Bentzon N, Düring M, Rasmussen BB, Mouridsen H, Kroman N. Prognostic effect of estrogen receptor status across age in primary breast cancer. Int J Cancer. 122(5):1089-94, 2008.
  3. Carey LA, Perou CM, Livasy CA, et al. Race, breast cancer subtypes, and survival in the Carolina Breast cancer Study. JAMA. 295(21):24922502, 2006.
  4. Yu KD, Wu J, Shen ZZ, Shao ZM. Hazard of breast cancer-specific mortality among women with estrogen receptor-positive breast cancer after five years from diagnosis: implication for extended endocrine therapy. J Clin Endocrinol Metab. 97(12):E2201-9, 2012.
  5. Truong PT, Bernstein V, Wai, E, et al. Age-related variations in the use of axillary dissection: A survival analysis of 8038 women with T1-ST2 breast cancer. Int J Radiat Oncol Biol Phys. 54(3):794-803, 2002.
  6. Sopik V, Sun P, Narod SA. The prognostic effect of estrogen receptor status differs for younger versus older breast cancer patients. Breast Cancer Res Treat. 165(2):391-402, 2017. 
  7. Jayasekara H, MacInnis RJ, Chamberlain JA, et al. Mortality after breast cancer as a function of time since diagnosis by estrogen receptor status and age at diagnosis. Int J Cancer. 145(12):3207-3217, 2019.

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