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Title: Steroid hormone receptors in the prediction of endocrine response in cancer of the breast
Author: Harland, Richard Nigel Leetall
Awarding Body: University of London
Current Institution: Imperial College London
Date of Award: 1985
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This thesis describes a study of the predictive value of assays of oestrogen (RE) and progesterone (RP) receptors for endocrine response in mammary cancer. The aim was assessment of the value of:- 1. Assays carried out routinely at the time of mastectomy 2. Classification by combinations of receptors 3. Assays of nuclear oestrogen receptors 4. Assays to show induction of progesterone receptor synthesis by tamoxifen Nuclear RE and cytosol receptors were measured by multiple-point methods with Scatchard analysis. A new microassay for RP was-also used and is described. Endocrine response was assessed by logrank analysis of the interval between the start of treatment and further progression of disease, and of survival both from presentation and 'first relapse*. The results showed that, although considerable variation of receptor status occurred with time, assays of RE or RP on primary tumours, whether 'early' or 'advanced', indicated effectively the probability both of relapse & survival. Assays of RE immediately before treatment predicted neither relapse nor survival, while assays of RP then indicated only the prognosis for survival. Assay of both cytosol receptors offered no advantage over assay of RP alone, or RE when the concentration was considered. Nuclear RE assays did not predict relapse, and gave only a weak indication of survival. Patients with increased concentrations of RP shortly after starting tamoxifen had a lower probability of relapse than those in whom RP declined, whose prognosis was similar to RP negative patients. The conclusions were 1 • Isoelectric focusing was a valid microassay. 2. Assays carried out on primary tumours were more reliable than assays done on metastases. 3. Assay of both receptors was unecessary. 4. Assay of RP was preferable to RE. 5. Assays of nuclear RE were unreliable. 6. Assays of RP in biopsies taken before & shortly after starting tamoxifen indicated the prognosis more effectively than a single assessment.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available