The role of the estrogen receptor in tumor progression.

We will discuss two estrogen receptor (ER) variants that may play a role in breast cancer initiation or progression. One is a truncated receptor, which has been named the exon 5 ER deletion variant, and the other is called a hyper-sensitive variant of the ER that is sensitive to low levels of hormone. Both ER variants differ from the wild-type ER in their hormone binding domains (HBD). The exon 5 ER deletion variant lacks a large portion of the HBD, while the hyper-sensitive ER variant has a point mutation in a conserved region of the HBD. The exon 5 ER deletion variant is transcriptionally active in the absence of hormone, and is thus considered constitutively-active. In contrast, the hyper-sensitive ER variant is functionally active in response to subphysiological concentrations of estrogen. We speculate that both ER variants may form productive heterodimers with wild-type receptor to modify the normal function of ER in the breast.