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 estrogenand/or progesterone-binding assays were available. Regardless of receptor status, patients treated with hormone therapy had prolonged survival (p <0.05), but had greater tumor burden at autopsy (p <0.05). The distributions of metastases differed for receptorpositive versus receptor-negative tumors. Estrogen-positive tumors metastasized more frequently to thyroid and/or parathyroid glands (p <0.01). Estrogen-negative tumors metastasized more extensively to the leptomeninges (p <0.01). Progesterone-positive tumors metastasized more frequently to myocardium (p <0.01), small bowel (p <0.01), urothelial structures (p <0.05), and thyroid and/or parathyroid glands (p <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.