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. 2013 May 14:7:317.
doi: 10.3332/ecancer.2013.317. Print 2013.

p16 expression correlates with basal-like triple-negative breast carcinoma

Amany A Abou-Bakr  1 , Hany I Eldweny
Affiliations

p16 expression correlates with basal-like triple-negative breast carcinoma

Amany A Abou-Bakr et al. Ecancermedicalscience. .

Abstract

Background: Basal-like breast carcinoma (BLBC) has attracted considerable attention over the past few years. It has been suggested that tumours expressing basal markers have a more aggressive clinical behaviour. However, a molecular basis for this disease remains unclear, and it lacks currently used therapeutic targets. Therefore developing a novel treatment strategy is crucial for improving the prognosis. The aim of this study was to characterise the immunohistochemical (IHC) expression of p16 in patients with BLBC compared with non-BLBC.

Materials and methods: Eighty-five cases of grade-3 invasive ductal carcinomas not otherwise specified (IDC-NOS) were analyzed. Immunohistochemical stains for oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor type 2 (HER2), cytokeratin (CK) 5/6, epidermal growth factor receptor (EGFR) and p16 were performed. BLBC was defined as ER-, PR-, Her2- and CK5/6+, and/or EGFR+.

Results: Twenty cases were categorised as BLBC versus 65 as non-basal. High mitotic count and presence of necrosis were associated with basal-like phenotype. Distant metastasis developed in 40% of cases of BLBC with frequent spread to brain and lung. p16 had significantly higher expression in the basal subgroup (80% versus 50.8%, P = 0.04). Patients with BLBCs were found to have a lower disease-free survival (DFS) rate (60% versus 70.8%, P = 0.03).

Conclusion: BLBC typically demonstrates a unique profile. p16 is frequently expressed in breast cancers with basal-like phenotype; this suggests that p16 may play a role in the poor prognosis of this tumour, and it may be used in the development of a targeted therapy that will result in improved patient prognostication and outcome.

Keywords: Basal-like; breast cancer; p16.

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Figures

Figure 1:
Figure 1:. A BLBC that is positive for (a) EGFR (x200) and for (b) CK5/6 (x400).
Figure 2:
Figure 2:. A BLBC showing (a) central necrosis (x200), and (b) sheets of markedly pleomorphic cells with conspicuous mitosis (x400).
Figure 3:
Figure 3:. A p16 stain revealing (a) negative reaction in non-BLBC (x400) and (b) diffuse cytoplasmic/nuclear positivity in BLBC (x200).
Figure 4:
Figure 4:. Kaplan-Meier DFS for basal versus non-basal tumours (P = 0.03).
See this image and copyright information in PMC

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