Ki-67 and p53 as Prognostic Factors for Luminal Type Breast Cancer
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Purpose: Breast cancer encompasses a heterogeneous population of tumors characterized by a variety of clinical, pathological, and molecular features. The estrogen receptor (ER) or progesterone receptor (PR) positive luminal types of breast cancer exhibits a better prognosis but are less chemosensitive. The aim of the study was to investigate the outcomes and the prognostic factors for the ER+ or PR+ luminal subtype in patients with breast cancer. Methods: In an investigation of 405 women with breast cancer who underwent surgery from 1994 to 2000, the expressions of ER and PR, and human epidermal growth factor receptor 2 (HER2) were evaluated. Medical records were retrospectively reviewed to find clinicopathological features. The subtypes were defined as luminal-A, luminal-B according to ER+ or PR+ and HER2 status. Results: To study subgroup analysis, the hazard ratio of the luminal A and B subtypes were 1.63 (95% confidence interval [CI], 0.46-5.73; p=0.45) and 2.43 (95% CI, 1.44-4.09; p<0.01), respectively. Univariate analysis showed that the pathological tumor stage and pathological axillary lymph node status were prognostic factors of recurrence-free survival (RFS) and overall survival (OS). However, expression of Ki-67 and p53 expression were associated with OS only in the univariate analysis. Conclusion: Ki-67 expression related to important prognostic factor in terms of both the RFS and the OS in patients with breast cancer by luminal type. In subgroup analysis, Ki-67 as well as p53 were reliable as important OS prognostic factors. The results indicate that more intensive adjuvant treatment will improve OS in patients with the luminal A subtype and Ki-67 or p53 expression.
Abstract
Purpose: Breast cancer encompasses a heterogeneous population of tumors characterized by a variety of clinical, pathological, and molecular features. The estrogen receptor (ER) or progesterone receptor (PR) positive luminal types of breast cancer exhibits a better prognosis but are less chemosensitive. The aim of the study was to investigate the outcomes and the prognostic factors for the ER+ or PR+ luminal subtype in patients with breast cancer. Methods: In an investigation of 405 women with breast cancer who underwent surgery from 1994 to 2000, the expressions of ER and PR, and human epidermal growth factor receptor 2 (HER2) were evaluated. Medical records were retrospectively reviewed to find clinicopathological features. The subtypes were defined as luminal-A, luminal-B according to ER+ or PR+ and HER2 status. Results: To study subgroup analysis, the hazard ratio of the luminal A and B subtypes were 1.63 (95% confidence interval [CI], 0.46-5.73; p=0.45) and 2.43 (95% CI, 1.44-4.09; p<0.01), respectively. Univariate analysis showed that the pathological tumor stage and pathological axillary lymph node status were prognostic factors of recurrence-free survival (RFS) and overall survival (OS). However, expression of Ki-67 and p53 expression were associated with OS only in the univariate analysis. Conclusion: Ki-67 expression related to important prognostic factor in terms of both the RFS and the OS in patients with breast cancer by luminal type. In subgroup analysis, Ki-67 as well as p53 were reliable as important OS prognostic factors. The results indicate that more intensive adjuvant treatment will improve OS in patients with the luminal A subtype and Ki-67 or p53 expression.
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