Estrogen receptor expression in atypical hyperplasia: Lack of association with breast cancer

Emily G. Barr Fritcher, Amy C Degnim, Lynn C. Hartmann, Derek C Radisky, Judy C Boughey, Stephanie S. Anderson, Robert A. Vierkant, Marlene H. Frost, Daniel W Visscher, Carol Reynolds

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Abstract

Estrogen receptor (ER) is expressed in normal and malignant breast epithelium, and expression levels have been found to increase with age in normal breast epithelium but not in atypical hyperplasia (AH) and carcinoma in situ. Here we assess ER expression in AH and its association with later breast cancer. ER expression was assessed immunohistochemically in archival sections from 246 women with AH who had open benign breast biopsy from 1967 to 1991. The ACIS III (Dako) was utilized to calculate ER expression in all atypical foci. Using multivariate linear regression, we examined associations of ER expression with age at biopsy, indication for biopsy, type of atypia, number of atypical foci, involution status, and family history. Breast cancer risk across levels of ER expression was also assessed compared with the Iowa SEER control population. Among 246 women, 87 (35%) had atypical ductal hyperplasia (ADH), 141 (57%) had atypical lobular hyperplasia (ALH), and 18 (7%) had both. Forty-nine (20%) developed breast cancer (median follow-up of 14.4 years). Multivariate analysis indicated that type of atypia and age at diagnosis were significantly associated with ER percent staining and intensity (P < 0.05). ER expression was increased in women with ADH and/or those over age 55. ER expression did not significantly impact breast cancer risk in patients diagnosed with atypia. We found increasing ER expression in AH with increasing age. ER expression in AH does not further discriminate breast cancer risk in women with atypia.

Original languageEnglish (US)
Pages (from-to)435-444
Number of pages10
JournalCancer Prevention Research
Volume4
Issue number3
DOIs
StatePublished - Mar 2011

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Estrogen Receptors
Hyperplasia
Breast Neoplasms
Breast
Carcinoma, Intraductal, Noninfiltrating
Biopsy
Epithelium
Carcinoma in Situ
Linear Models
Multivariate Analysis
Staining and Labeling

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Estrogen receptor expression in atypical hyperplasia : Lack of association with breast cancer. / Barr Fritcher, Emily G.; Degnim, Amy C; Hartmann, Lynn C.; Radisky, Derek C; Boughey, Judy C; Anderson, Stephanie S.; Vierkant, Robert A.; Frost, Marlene H.; Visscher, Daniel W; Reynolds, Carol.

In: Cancer Prevention Research, Vol. 4, No. 3, 03.2011, p. 435-444.

Research output: Contribution to journalArticle

Barr Fritcher, Emily G. ; Degnim, Amy C ; Hartmann, Lynn C. ; Radisky, Derek C ; Boughey, Judy C ; Anderson, Stephanie S. ; Vierkant, Robert A. ; Frost, Marlene H. ; Visscher, Daniel W ; Reynolds, Carol. / Estrogen receptor expression in atypical hyperplasia : Lack of association with breast cancer. In: Cancer Prevention Research. 2011 ; Vol. 4, No. 3. pp. 435-444.
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