EVALUATION OF THE EFFECTS OF BIOLOGICAL PROGNOSTIC an‎d PREDICTIVE FACTORS ON SURVIVAL OF BREAST CANCER PATIENTS

The molecular basis of metastatic potential of human breast carcinoma cells can be useful information to determine the practical implications in the diagnosis, determining prognosis and treatment of breast cancer. The aim of this study was to identify predictors of aggressive biological behavior and metastatic potential in breast carcinoma among a number of intrinsic biomarkers of tumor cells. We used routine formalin fixed, paraffin embedded tumor samples; sections were stained immunohistochemically to determine the expression of estrogen receptor (ER), progesterone receptor (PR), HER2/neu, Ki67, p53 and cathepsin D in 66 breast carcinoma patients. The result of the quantitative immunohistochemical assays were correlated with clinical and histological data such as patient age, tumor size, axillary lymph node status, tumor grade, the therapeutic regimens and survival rates. Univariate analysis revealed a statistically significant relation between tumor size and overexpression of p53, and between tumor grade and PR status, p53 status and Ki67. In multivariate analysis the independent factors predicting for tumor grade were Ki67 and PR status. Among patients with ER expression, negative p53 or Ki67 status, tumors with lower grades and negative axillary lymph nodes (or < 4 involved lymph nodes), there was a higher survival rate (either disease free or overall); however, relationship was not statistically significant, most probably due to the low number of studied patients. In conclusion, Ki67 was an independent factor to predict tumor grade in our study; the use of this proliferation activity marker in routine approach to patients with breast cancer is recommended, at least to evaluate the accuracy of tumor grading by mitotic count.