Japanese Journal of Clinical Oncology, Vol 27, Issue 6 371-377, Copyright © 1997 by Foundation for Promotion of Cancer Research
GJ Zhang, H Tsuda, I Adachi, T Fukutomi, H Yamamoto and S Hirohashi
Patients with primary breast carcinoma with one to three axillary lymph
node metastases but without distant metastases (n1-3) in Japan have been
shown to have a 10-year disease-free survival rate of > 60%. It would be
reasonable to divide n1-3 Japanese breast cancer patients into groups with
high- or low-risk for recurrence and to consider post-operative adjuvant
therapy. In the present study, we analyzed 228 consecutive Japanese
patients with n1-3 breast cancer who underwent radical mastectomy and were
followed up for a median time of 11.0 years. The expression of bcl-2, p53
and c-erbB-2 proteins in the primary tumors was examined
immunohistochemically and their prognostic roles were also analyzed along
with conventional clinicopathologic indicators. bcl-2 expression was
correlated with positive estrogen receptor status and inversely correlated
with p53, c-erbB-2 and histologic grade. Univariate analysis showed that
bcl-2, p53 and c-erbB-2 expression were prognostic indicators of the
patient's group as well as node status, histologic grade, tumor size, age
at diagnosis, menopausal status and estrogen receptor status. Cox's
regression analysis demonstrated that the number of nodes involved,
menopausal status, p53 and bcl-2 were independent predictors for overall
survival and that histologic grade and the number of nodes involved were
independent predictors for disease-free survival. These results suggest
that bcl-2 expression in combination with p53 and c-erbB-2 expression, the
number of lymph node metastases, histologic grade and menopausal status are
useful in selecting subgroups of n1-3 breast cancer patients with good or
poor prognoses.
ORIGINAL ARTICLE
Prognostic indicators for breast cancer patients with one to three regional lymph node metastases, with special reference to alterations in expression levels of bcl-2, p53 and c-erbB-2 proteins
Department of Clinical Oncology, National Cancer Center Hospital and Research Institute, Tokyo, Japan.
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