- Breast carcinoma, inflammatory
- Prognostic factors
- Survival, breast carcinoma
Objective: The aim of this study was to determine the markers of prognosis in metastatic inflammatory breast cancer (IBC). Subjects and Methods: The prognostic value of patients’ clinical characteristics and expression of c-erbB-2, p53, Ki-67, ER and PgR were assessed in the 45 patients with IBC who had developed distant metastasis. Immunohistochemical methods were used to detect the expression of c-erbB-2, p53, Ki-67, ER and PgR in surgical resection specimens of the patients’ primary tumor. Results: The median overall survival (OS) measured from the diagnosis of metastatic disease was 23 months. In the univariate analysis, p53 protein accumulation and the presence of visceral metastasis were predictive of poor survival (p = 0.01 and 0.003, respectively). In the multivariate analysis, accumulation of p53 protein and the presence of visceral metastasis correlated with OS (p = 0.02 and 0.008, respectively). Conclusion: In metastatic IBC, accumulation of p53 protein and presence of visceral metastasis are independent prognostic factors for OS. Established prognostic factors in non-IBC patients such as patient age, histologic grade, hormone receptor status and c-erbB-2 status did not have independent significance in IBC in this study.
Copyright © 2011 S. Karger AG, Basel
- Chang S, Parker SL, Pham T, Buzdar AU, Hursting SD: Inflammatory breast carcinoma incidence and survival: the surveillance, epidemiology, and end results program of the National Cancer Institue, 1975–1992. Cancer 1998;82:2366–2372.
- Haagenson CD: Diseases of the Breast, ed 2. Philadelphia, Saunders, 1971, pp 576– 584.
- Taylor G, Meltzer A: Inflammatory carcinoma of the breast. Am J Cancer 1938;33:33–49.
- Cristofanilli M, Buzdar AU, Hortobagyi GN: Update on the management of inflammatory breast cancer. Oncologist 2003;8:141–148.
- Buzdar AU, Singletary SE, Booser DJ, Frye DK, Wasaff B, Hortobagyi GN: Combined modality treatment of stage III and inflammatory breast cancer: M D Anderson Cancer Center experience. Surg Oncol Clin N Am 1995;4:715–734.
- Riou G, Le MG, Travagli JP, Levine AJ, Moll UM: Poor prognosis of p53 gene mutation and nuclear overexpression of p53 protein in inflammatory breast carcinoma. J Natl Cancer Inst 1993;85:1765–1767.
- Bonnefoi H, Diebold-Berger S, Therasse P, Hamilton A, van de Vijver M, MacGrogan G, Shepherd L, Amaral N, Duval C, Drijkoningen R, Larsimont D, Piccart M: Locally advanced/inflammatory breast cancers treated with intensive epirubicin-based neoadjuvant chemotherapy: are there molecular markers in the primary tumour that predict for 5-year clinical outcome? Ann Oncol 2003;14:406–413.
- Gonzalez-Angulo AM, Sneige N, Buzdar AU, Valero V, Kau SW, Broglio K, Yamamura Y, Hortobagyi GN, Cristofanilli M: p53 expression as a prognostic marker in inflammatory breast cancer. Clin Cancer Res 2004;10:6215–6221.
- Sawaki M, Ito Y, Akiyama F, Tokudome N, Horii R, Mizunuma N, Takahashi S, Horikoshi N, Imai T, Nakao A, Kasumi F, Sakamoto G, Hatake K: High prevalence of HER-2/neu and p53 overexpression in inflammatory breast cancer. Breast Cancer 2006;13:172–178.
- World Health Organization: WHO Handbook for Reporting Results of Cancer Treatment. Geneva, World Health Organization, 1979.
- Faille A, De Cremoux P, Extra JM, Linares G, Espie M, Bourstyn E, De Rocquancourt A, Giacchetti S, Marty M, Calvo F: p53 mutations and overexpression in locally advanced breast cancers. Br J Cancer 1994;69:1145–1150.
- Eicheler W, Zips D, Dorfler A, Grénman R, Baumann M: Splicing mutations in TP53 in human squamous cell lines influence immunohistochemical detection. J Histochem Cytochem 2002;50:197–203.
- Logullo AF, de Moura RP, Nonogaki S, Kowalski LP, Nagai MA, Simpson AJ: A proposal for the integration of immunohistochemical staining and DNA-based techniques for the determination of TP53 mutations in human carcinomas. Diagn Mol Pathol 2000;9:35–40.
- Clark G, Sledge GWJ, Osborne CK, McGuire WL: Survival from first recurrence: relative importance of prognostic factors in 1015 breast cancer patients. J Clin Oncol 1987;5:55–61.
- Insa A, Lluch A, Prosper F, Marugan I, Martinez-Agullo A, Garcia-Conde J: Prognostic factors predicting survival from first recurrence in patients with metastatic breast cancer: analysis of 439 patients. Breast Cancer Res Treat 1999;56:67–78.
- Chang J, Clark GM, Allred DC, Mohsin S, Chamness G, Elledge RM: Survival of patients with metastatic breast carcinoma: importance of prognostic markers of the primary tumor. Cancer 2003;97:545–553.
- Efficace F, Biganzoli L, Piccart M, Coens C, Van Steen K, Cufer T, Coleman RE, Calvert HA, Gamucci T, Twelves C, Fargeot P, Bottomley A; EORTC-BCG-IDBBC-NDDG; EORTC-BCG-IDBBC-NDDG: Baseline health-related quality-of-life data as prognostic factors in a phase III multicentre study of women with metastatic breast cancer. Eur J Cancer 2004;40:1021–1030.
- Elledge RM, Allred DC: Prognostic and predictive value of p53 and p21 in breast cancer. Breast Cancer Res Treat 1998;52:79–98.
- Lacroix M, Toillon RA, Leclercq G: p53 and breast cancer, an update. Endocr Relat Cancer 2006;13:293–325.
- Bottini A, Berruti A, Bersiga A, Brizzi MP, Brunelli A, Gorzegno G, DiMarco B, Aguggini S, Bolsi G, Cirillo F, Filippini L, Betri E, Bertoli G, Alquati P, Dogliotti L: p53 but not bcl-2 immunostaining is predictive of poor clinical complete response to primary chemotherapy in breast cancer patients. Clin Cancer Res 2000;6:2751–2758.
- Clahsen PC, van de Velde CJ, Duval C, Pallud C, Mandard AM, Delobelle-Deroide A, van den Broek L, Sahmoud TM, van de Vijver MJ: p53 protein accumulation and response to adjuvant chemotherapy in premenopausal women with node-negative early breast cancer. J Clin Oncol 1998;16:470–479.
- Mottolese M, Benevolo M, Del Monte G, Buglioni S, Papaldo P, Nisticò C, Di Filippo F, Vasselli S, Vici P, Botti C: Role of P53 and BCL-2 in high-risk breast cancer patients treated with adjuvant anthracycline-based chemotherapy. J Cancer Res Clin Oncol 2000;126:722–729.
- Rahko E, Blanco G, Soini Y, Bloigu R, Jukkola A: A mutant TP53 gene status is associated with a poor prognosis and anthracycline resistance in breast cancer patients. Eur J Cancer 2003;39:447–453.
- Wahl AF, Donaldson KL, Fairchild C, Lee FY, Foster SA, Demers GW, Galloway DA: Loss of normal p53 function confers sensitization to Taxol by increasing G2/M arrest and apoptosis. Nat Med 1996;2:72–79.
- Sjostrom J, Blomqvist C, Heikkila P, Boguslawski KV, Räisänen-Sokolowski A, Bengtsson NO, Mjaaland I, Malmström P, Ostenstadt B, Bergh J, Wist E, Valvere V, Saksela E: Predictive value of p53, mdm-2, p21, and mib-1 for chemotherapy response in advanced breast cancer. Clin Cancer Res 2000;6:3103–3110.
- Schmidt M, Bachhuber A, Victor A, Steiner E, Mahlke M, Lehr HA, Pilch H, Weikel W, Knapstein PG: p53 expression and resistance against paclitaxel in patients with metastatic breast cancer. J Cancer Res Clin Oncol 2003;129:295–302.
- Anelli A, Brentani RR, Gadelha AP, Amorim De Albuquerque A, Soares F: Correlation of p53 status with outcome of neoadjuvant chemotherapy using paclitaxel and doxorubicin in stage IIIB breast cancer. Ann Oncol 2003;14:428–432.
- Sezgin C, Karabulut B, Uslu R, Sanli UA, Goksel G, Zekioglu O, Ozdemir N, Goker E: Potential predictive factors for response to weekly paclitaxel treatment in patients with metastatic breast cancer. J Chemother 2005;17:96–103.
Canfeza Sezgin, MD
Ege University Medical Faculty, Division of Medical Oncology
Tulay Aktas Oncology Hospital
TR–35100 Bornova/Izmir (Turkey)
Tel./Fax +90 232 374 7321, E-Mail firstname.lastname@example.org
Received: October 27, 2009
Accepted: May 19, 2010
Published online: January 20, 2011
Number of Print Pages : 6
Number of Figures : 3, Number of Tables : 2, Number of References : 28
Medical Principles and Practice (International Journal of the Kuwait University Health Sciences Centre)
Vol. 20, No. 2, Year 2011 (Cover Date: January 2011)
Journal Editor: Owunwanne A. (Kuwait)
ISSN: 1011-7571 (Print), eISSN: 1423-0151 (Online)
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