Introduction
Materials and methods
Patients and breast cancer tissues
Number of patients (percentage) | ||
---|---|---|
Total number of patients | 73 | |
Age at diagnosis (years) | ≤50 >50 | 34 (46.6) 39 (53.4) |
Range | 29 to 77 | |
Tumour size (cm) | <2.0 ≥2.0 | 20 (27.4) 53 (72.6) |
Number of positive lymph nodes | 0 1–3 >3 | 21 (28.8) 20 (27.4) 32 (43.8) |
Histological grade | 1 2 3 | 12 (16.4) 42 (57.5) 19 (26.1) |
Adjuvant therapy | None Endocrine therapy Chemotherapy Combined | 5 (6.9) 32 (43.8) 2 (2.7) 34 (46.6) |
Disease-free interval (months) | Mean ± SD Median | 39.8 ± 25.7 38 |
Range | 2 to 123 | |
First-line endocrine therapy for metastatic breast cancer | Tamoxifen Aromatase inhibitors LHRH agonist LHRH agonist + tamoxifen Fulvestrant | 56 (76.7) 9 (12.3) 3 (4.1) 4 (5.5) 1 (1.4) |
First-line endocrine therapy for metastatic breast cancer and response criteria
Immunohistochemical analysis for ER-α, PR, HER2, p53, and Ki67
Immunohistochemical scoring
Statistical analysis
Results
Correlation between HER2, p53, and Ki67 expression and clinicopathological factors
HER2 | P53 | Ki67 | ||||
---|---|---|---|---|---|---|
Positive/total (percentage) |
P
| Positive/total (percentage) |
P
| Positive/total (percentage) |
P
| |
Total | 9/73 (12.3) | 16/73 (21.9) | 26/73 (35.6) | |||
Tumour size (cm) | ||||||
<2.0 | 4/20 (20.0) | 0.41 | 5/20 (25.0) | 0.94 | 7/20 (35.0) | >0.99 |
≥2.0 | 5/53 (9.4) | 11/53 (20.8) | 19/53 (35.8) | |||
Number of positive lymph nodes | ||||||
0 | 1/22 (4.5) | 0.34 | 3/22 (12.6) | 0.41 | 6/22 (27.2) | 0.47 |
≥1 | 8/51 (15.7) | 13/51 (25.5) | 20/51 (39.2) | |||
Histological grade | ||||||
1 | 0/12 (0) | 0.36 | 0/12 (0) | 0.05 | 3/12 (25.0) | 0.18 |
2 | 6/42 (14.3) | 9/42 (21.4) | 13/42 (31.0) | |||
3 | 3/19 (15.8) | 7/19 (36.8) | 10/19 (52.6) | |||
Estrogen receptor-α | ||||||
Negative | 4/17 (23.5) | 0.23 | 5/17 (29.4) | 0.60 | 8/17 (47.1) | 0.40 |
Positive | 5/56 (8.9) | 11/56 (19.6) | 18/56 (32.1) | |||
Progesterone receptor | ||||||
Negative | 3/18 (16.7) | 0.81 | 5/18 (27.8) | 0.71 | 9/18 (50.0) | 0.23 |
Positive | 6/55 (10.9) | 11/55 (20.0) | 17/55 (30.9) |
p53 protein accumulation and Ki67 expression in primary breast tumours are predictive of endocrine therapy resistance in metastatic breast cancer
HER2 | P53 | Ki67 | ||||
---|---|---|---|---|---|---|
Positive/total (percentage) |
P
| Positive/total (percentage) |
P
| Positive/total (percentage) |
P
| |
Response to endocrine therapy (n = 73) | ||||||
Total | 9/73 (12.3) | 16/73 (21.9) | 26/73 (35.6) | |||
Responders | 1/34 (2.9) | 0.054 | 2/34 (5.9) | 0.0049a
| 7/34 (20.6) | 0.024a
|
Non-responders | 8/39 (20.5) | 14/39 (35.9) | 19/39 (48.7) |
Patients with HER2 overexpression and p53 protein accumulation in primary breast tumours had a significantly shorter survival after relapse
Univariate | Multivariate | |||||
---|---|---|---|---|---|---|
P
| RR | 95% CI |
P
| RR | 95% CI | |
Age | 0.67 | 0.882 | 0.494–1.576 | |||
Tumour size | 0.21 | 1.483 | 0.797–2.759 | |||
Lymph node status | 0.40 | 0.746 | 0.376–1.479 | |||
Histological grade | 0.15 | 0.500 | 0.197–1.271 | |||
ER-α | 0.0009a
| 0.342 | 0.181–0.645 | 0.79 | 1.174 | 0.354–3.886 |
PR | 0.0012a
| 0.358 | 0.192–0.668 | 0.045a
| 0.291 | 0.087–0.972 |
HER2 | 0.0024a
| 3.637 | 1.582–8.362 | 0.0046a
| 3.710 | 1.498–9.191 |
p53 | 0.0002a
| 3.371 | 1.765–6.440 | 0.013a
| 2.364 | 1.198–4.665 |
Ki67 | 0.16 | 1.539 | 0.849–2.790 |