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To the Editor: Estrogen-receptor (ER) levels are an important predictor of breast cancer prognosis. When combined with other prognostic information, ER status is predictive of disease-free survival.¹ Although ER status is commonly used in the medical literature, its cutoff value is still arbitrary. For example, in the Early Breast Cancer Trialists' Collaborative Group's study,² ER-positivity was defined as at least 10 fmol ER per milligram of cytosol protein, while Clark et al³ defined ER positivity as at least 3 fmol/mg of protein-specific binding sites. Without a consensus on the cutoff point, it is difficult to make medical decisions based on these research findings.

Cummings and colleagues⁴ concluded that raloxifene decreased the risk of ER-positive breast cancer by 90%. Even though their results are promising, the definition of ER status was not provided. Inclusion of the ER cutoff point would have made this study more valuable.

In addition, the relative risk . . . [Full Text of this Article]

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The Effect of Raloxifene on Risk of Breast Cancer in Postmenopausal Women: Results From the MORE Randomized Trial
Steven R. Cummings, Stephen Eckert, Kathryn A. Krueger, Deborah Grady, Trevor J. Powles, Jane A. Cauley, Larry Norton, Thomas Nickelsen, Nina H. Bjarnason, Monica Morrow, Marc E. Lippman, Dennis Black, Joan E. Glusman, Alberto Costa, and V. Craig Jordan
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