Hormone relationships in breast cancer: the role of receptor-binding proteins.

The introduction of receptor protein studies as markers for hormone dependence of breast carcinomas has had a profound effect on the management of advanced disease. All breast carcinomas, regardless of stage, should have receptor binding protein studies for estrogen and progesterone by the sucrose gradient method or by the dextran-coated charcoal method as a good alternative. A simpler test is needed. In cases of primary advanced disease or in recurrent disease, receptor binding protein studies effectively identify the subgroup of hormone-dependent tumors that should be managed by surgical hormone ablation or endocrine manipulation. These tests are even more effective in identifying patients that should not receive hormone therapy and respond better to chemotherapy. In primary, potentially surgically curable disease, receptor studies may serve as a therapeutic guide to adjuvant hormone or chemotherapy. In all breast cancers, ER and PgR receptor studies should be performed and the information should be stored for possible future use. If possible, tisssue should be stored in a freezer in anticipation of future tests and for confirmation of hormone dependence in the event of recurrence.