Absence of estrogen receptor alpha (ESR1) gene amplification in a series of breast cancers in Taiwan

Immunohistochemical expression of ER alpha, encoded by the ESR1 (estrogen receptor 1) gene located at 6q25.1, is the most important determinant of responsiveness to endocrine therapy in breast cancer. The prevalence and significance of ESR1 amplification in breast cancer remain controversial. We set out to assess ESR1 status and its relevance in breast cancer in Taiwan. We tested tissue samples from 311 invasive carcinomas in a tissue microarray for ESR1 status by fluorescent in situ hybridization (FISH) and chromogenic in situ hybridization (CISH). In order to examine its association with ER alpha and ESR1 status, HER2 status was determined by FISH. Of the carcinomas, 58.8%(183/311) was ER alpha positive. None of the carcinomas showed amplification of ESR1 by either method, whereas 24.1 % (75/311) of the carcinomas harbored HER2 amplification. Of the carcinomas, 9.6 % (26/301) showed ESR1 gain (1.3 <= ratio ESR1/chromosome 6<2) by FISH and 10 % (24/299) by CISH. FISH and CISH results showed a good correlation (kappa-coefficient=0.786). ESR1 gain by FISH and CISH was significantly associated with high-grade (P=0.0294 and 0.0417, respectively) but not with ER alpha expression, HER2 status, or overall survival. ER alpha positivity was significantly associated with better overall survival (P=0.039). HER2 amplification was significantly related with poor overall survival (P=0.002). Our data confirm that in breast cancer, HER2 amplification is a frequent genetic aberration and a negative prognostic factor, and show that ESR1 amplification is not a key genetic abnormality in the tumorigenesis of breast cancer in Taiwan.