Hormone Receptor Status of a Contralateral Breast
Cancer Is Independent of the Receptor Status of the First
Primary in Patients Not Receiving Adjuvant Tamoxifen G. Arpino, H.L. Weiss, G.M. Clark, S.G. Hilsenbeck, and C.K. Osborne A B S T R A C T Purpose
To determine whether the hormone receptor status of the primary breast cancer (PBC) is
predictive of the hormone receptor status of the subsequent contralateral breast cancer (CBC). Patients and Methods
We identied patients in our database with known estrogen receptor (ER; n 193) and/or progesterone receptor (PgR; n 178) status in their PBC and in their subsequent CBC. One hundred twenty-six of these patients had received no adjuvant therapy, 34 had received
adjuvant tamoxifen, and 33 had received adjuvant chemotherapy alone. The median interval
between the rst diagnosis of PBC and the development of the subsequent CBC was 3
years. ER and PgR assays were assessed biochemically in two central reference laboratories
using identical quality-controlled ligand-binding methods. Results
Among systemically untreated patients (n 126), 88% of patients with ER-positive PBC and 75% of patients with ER-negative PBC developed an ER-positive CBC (P .11). Among the tamoxifen-treated patients, those with an ER-positive PBC were almost equally likely to
develop an ER-positive (47%) or ER-negative (53%) CBC (P .99). PgR status was similar. In the untreated group (n 112), 59% of patients with a PgR-positive PBC and 66% with a PgR-negative PBC developed a PgR-positive CBC (P .48). Among tamoxifen-treated patients (n 33), 50% of patients with a PgR-positive PBC versus 27% of patients with a PgR-negative PBC developed a PgR-positive CBC (P .28). Conclusion
ER and PgR status of the primary tumor does not predict the hormone receptor status of the
subsequent CBC in the absence of selective pressure of adjuvant therapy. Thus, other
reasons should be considered to clarify the failure of tamoxifen to reduce the incidence of
CBC in patients with a receptor-negative PBC. J Clin Oncol 23:4687-4694.