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Outcomes in young women with breast cancer of triple-negative phenotype: the prognostic significance of CK19 expression.
- Source :
-
International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2008 Jan 01; Vol. 70 (1), pp. 35-42. Date of Electronic Publication: 2007 Sep 12. - Publication Year :
- 2008
-
Abstract
- Purpose: Basal-like carcinoma of the breast is associated with genetic instability and aggressive behavior. In this study, we evaluated the luminal cytokeratin marker CK-19 in young women with breast cancer treated with conservative surgery and radiation therapy (CS+RT).<br />Methods: Primary tumor specimens from a cohort of 158 young premenopausal women (range, 25-49 years) treated with CS+RT with a median follow-up of 6.25 years were constructed into a tissue microarray. The array was stained for ER, PR, HER2, CK19, and p53. The molecular profiles were correlated with clinical-pathologic factors, overall, local, and distant relapse-free survival. The association between CK19, other co-variables, and outcome was assessed in a multivariate model.<br />Results: Positive expression of ER, PR, HER-2/neu, CK19, and p53 were 33.1%, 34.5%, 10.0%, 79.5%, and 20.9%, respectively. With 20 local relapses and 38 distant metastases, the 10-year overall, breast relapse-free, and distant relapse-free survival were 79.65%, 87.29%, and 67.35%, respectively. Tumor stage and nodal status were associated with distant relapse-free and overall survival. In multivariate analysis, CK19 negativity was a predictor poor local (RR, 3.54; 95% CI, 1.87-7.65; p < 0.01) distant (RR, 1.44; 95% CI, 0.86-2.70; p = 0.17), and overall survival (RR, 1.89; 95% CI, 1.04-3.55; p = 0.03).<br />Conclusions: Lack of CK19 expression identifies a subset of patients with a significantly higher risk of local relapse. Distant relapse and overall survival rates also correlated with CK19 negativity. Further evaluation of the prognostic significance of basal and luminal cytokeratins in young women with breast cancer is warranted.
- Subjects :
- Adult
Analysis of Variance
Breast Neoplasms genetics
Breast Neoplasms radiotherapy
Breast Neoplasms surgery
Chi-Square Distribution
Combined Modality Therapy methods
Disease-Free Survival
Female
Humans
Middle Aged
Neoplasm Recurrence, Local
Protein Array Analysis methods
Receptor, ErbB-2 analysis
Receptors, Estrogen analysis
Receptors, Progesterone analysis
Tumor Suppressor Protein p53 analysis
Biomarkers, Tumor analysis
Breast Neoplasms chemistry
Keratin-19 analysis
Subjects
Details
- Language :
- English
- ISSN :
- 0360-3016
- Volume :
- 70
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International journal of radiation oncology, biology, physics
- Publication Type :
- Academic Journal
- Accession number :
- 17855007
- Full Text :
- https://doi.org/10.1016/j.ijrobp.2007.05.066