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A breast cancer counts as oestrogen receptor negative when fewer than 1 in 100 of its cells stain for the receptor, and the same rule applies to progesterone receptor. Tumours with 1 to 10 percent staining are labelled ER low positive, but they behave like triple-negative cancers and in some countries are treated as such.
The ASCO/CAP guideline recommends ER testing of invasive breast cancers by validated immunohistochemistry as the standard for predicting endocrine therapy benefit: samples with 1 to 100 percent of tumour nuclei positive are ER positive; fewer than 1 percent or 0 percent is ER negative; and because data on endocrine benefit for 1 to 10 percent staining are limited, those samples are reported in a new category, ER Low Positive, with a recommended comment, laboratory standard operating procedures for low or absent staining, and the status of controls reported for 0 to 10 percent cases; the same principles apply to PR, which is used mainly for prognosis in ER-positive disease (Allison 2020). NICE NG101 asks for ER, PR and HER2 to be assessed together at diagnosis, ER by standardised quality-assured immunohistochemistry reported quantitatively, and defines triple-negative as each scored negative under local multidisciplinary team guidelines (NG101 1.3 and the terms section). The ER-low band behaves like triple-negative disease: in a US registry of 516 stage I to III HER2-negative patients with ER and PR of 10 percent or less, the 12.6 percent with 1 to 10 percent staining matched the rest for germline BRCA prevalence, chemotherapy use, pathological complete response (51.3 against 49.2 percent) and three-year recurrence-free (82.4 against 82.5 percent) and overall survival (Yoder 2022); in 406 Italian patients ER 1 to 9 percent tumours had the same five-year relapse-free (73.1 against 74.0 percent) and overall survival (76.7 against 82.3 percent) and pathological complete response (44 against 38 percent) as ER-negative tumours (Dieci 2021); and Sweden kept a 10 percent threshold when international guidelines dropped to 1 percent in 2010, treating ER 1 to 9 percent HER2-negative tumours as triple-negative, with 9.9 percent of 5,655 tumours in 2008 to 2020 in that band and no survival difference from ER-zero disease (Acs 2024). The practical consequence is that ER-low patients are often excluded from triple-negative trials of immunotherapy and ADCs, so evidence for those drugs in the band is thin (Yoder 2022).
Most cancers start in the ducts and drain first to the axillary nodes, which is why the armpit is checked and a sentinel node is sampled.
Same organ: Breast cancer (all types), HR-positive / HER2-negative breast cancer, HER2-positive breast cancer, Male breast cancer, Ductal carcinoma in situ (DCIS), High-risk early HR-positive breast cancer, HR-positive metastatic breast cancer after CDK4/6 inhibitors, HER2-low and HER2-ultralow metastatic breast cancer, Early HER2-positive breast cancer, HER2-positive breast cancer with brain metastases, Early triple-negative breast cancer, Metastatic triple-negative breast cancer, Basal-like 1 triple-negative breast cancer (BL1), Basal-like 2 triple-negative breast cancer (BL2), Mesenchymal triple-negative breast cancer (M), Mesenchymal stem-like triple-negative breast cancer (MSL), Luminal androgen receptor triple-negative breast cancer (LAR), Immunomodulatory triple-negative breast cancer (IM), Metaplastic breast carcinoma, Carcinoma with medullary pattern (medullary breast cancer), Adenoid cystic carcinoma of the breast, Apocrine carcinoma of the breast, Secretory carcinoma of the breast, BRCA-associated triple-negative breast cancer, Inflammatory breast cancer, Paget disease of the nipple, Phyllodes tumour of the breast, Invasive lobular carcinoma of the breast, Invasive breast carcinoma of no special type (invasive ductal carcinoma), Tubular carcinoma of the breast, Mucinous carcinoma of the breast, Papillary carcinomas of the breast (encapsulated, solid and invasive papillary), Invasive cribriform carcinoma of the breast, Invasive breast carcinoma with medullary pattern (medullary carcinoma), Invasive micropapillary carcinoma of the breast, Neuroendocrine neoplasms of the breast, Lobular carcinoma in situ (LCIS)
Showing the organ this term concerns: Triple-negative breast cancer (TNBC).
Shares Pathologic complete response (pCR), Early triple-negative breast cancer, Triple-negative breast cancer (TNBC) and the tags breast, tnbc.
Shares Pathologic complete response (pCR), Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer and the tags breast, tnbc.
Shares Pathologic complete response (pCR), Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer and the tags breast, tnbc.
Shares Early triple-negative breast cancer, Triple-negative breast cancer (TNBC) and the tags breast, tnbc.
Shares Pathologic complete response (pCR), Triple-negative breast cancer (TNBC) and the tags breast, tnbc.
Shares Pathologic complete response (pCR), Triple-negative breast cancer (TNBC) and the tags breast, tnbc.
Shares Pathologic complete response (pCR), Early triple-negative breast cancer, Triple-negative breast cancer (TNBC) and the tags breast, tnbc.
Shares Early triple-negative breast cancer, Triple-negative breast cancer (TNBC) and the tags breast, tnbc.