Estrogen and progesterone receptors in prediction of metastatic behavior of breast carcinoma.

The relation between estrogen- and progesterone-binding receptors and the metastatic behavior of breast carcinoma was examined by reviewing autopsy findings in 25 subjects with metastatic breast cancer at Johns Hopkins Hospital for whom the results of estrogen- and/or progesterone-binding assays were available. Regardless of receptor status, patients treated with hormone therapy had prolonged survival (p less than 0.05), but had greater tumor burden at autopsy (p less than 0.05). The distributions of metastases differed for receptor-positive versus receptor-negative tumors. Estrogen-positive tumors metastasized more frequently to thyroid and/or parathyroid glands (p less than 0.01). Estrogen-negative tumors metastasized more extensively to the leptomeninges (p less than 0.01). Progesterone-positive tumors metastasized more frequently to myocardium (p less than 0.01), small bowel (p less than 0.01), urothelial structures (p less than 0.05), and thyroid and/or parathyroid glands (p less than 0.05). These differences in the distributions of metastases may reflect different tissue preferences in metastasizing breast carcinoma cells with estrogen- and/or progesterone-binding receptors. In this regard, perhaps patients with estrogen-negative tumors should be monitored closely for the development of carcinomatous meningitis, because this form of central nervous system involvement is a frequent cause of death among patients with breast carcinoma.