Oestrogen receptors and breast cancer: are we prepared to move forward? A critical review

Abstract

It is nearly 60 years since the identification of the oestrogen hormone receptor (ER) in breast cancer, a discovery that radically transformed the clinical management of the disease. Hormonal therapy with anti-oestrogens (Tamoxifen and Aromatase inhibitors) antagonises ER function and became the mainstay treatment until today. Around 70% of breast tumours are classified as oestrogen dependent, yet the mechanism of action of other hormones in breast cancer growth both independently and interacting with ER as well as their targeted therapies have yet to find a place in the clinic. In this article, I critically review the scientific literature for the period 1960–2016 and examine the rise and persistence of the oestrogen hypothesis as well as the neglect of alternative hormonal explanations. By using Pierre Bourdieu’s concepts of the scientific field alongside feminist science scholars to explore the impact of gendered assumptions on science, the analysis provides insight into the dominant role of the oestrogen hypothesis and the struggles for legitimation of different alternative perspectives. I consider these alternative approaches as “internal” struggles for scientific authority, which are in turn, socially determined by “external” gender values that reinforce a binary arrangement of male/female bodies based on fixed molecular hormonal traits.