Annals of Surgical Oncology

, Volume 3, Issue 1, pp 8–14 | Cite as

p-Glycoprotein expression as a predictor of breast cancer recurrence

  • Sharon Gregorcyk
  • Yuan Kang
  • Dörthe Brandt
  • Paul Kolm
  • Gerry Singer
  • Roger R. Perry
Best Clinical Research Paper


Background: Many new prognostic factors for breast cancer have been described, and yet the ability to predict patient outcomes remains poor. Overexpression of p-glycoprotein (p-gp), the multidrug resistance efflux pump, confers a worse prognosis to patients with certain leukemias and other tumors. The purpose of this study was to analyze the potential usefulness of p-gp expression as a prognostic factor in patients with breast cancer.

Methods: Paraffin blocks were obtained from 55 previously untreated patients who underwent surgery between 1987 and 1988. To determine p-gp expression, tumor cell suspensions were incubated with the p-gp-specific C219 monoclonal antibody and analyzed using an indirect immunofluorescent flow cytometric assay.

Results: Twenty-four (44%) of the tumors were p-gp positive and 31 (56%) were p-gp negative. Among the p-gp positive patients, 65% had recurrence of their disease, whereas only 13% of the p-gp negative patients experienced recurrence (p=0.0001). The 5-year disease-free rate for p-gp positive patients was 39% compared with 83% for p-gp negative patients (p=0.0001). In univariate analysis examining 10 different variables, significant predictors of recurrence were p-gp, stage, and tumor size. Multivariate analysis using Cox Proportional Hazards regression showed that only p-gp and stage were significant independent predictors of recurrence (p=0.0002).

Conclusions: p-gp is frequently expressed in patients with untreated breast cancer, with p-gp-positive patients being at significantly greater risk for disease recurrence. p-gp appears to be a useful prognostic factor in breast cancer and could potentially help guide management.

Key Words

Breast cancer p-glycoprotein Prognostic factor Recurrence Multidrug resistance 


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Copyright information

© The Society of Surgical Oncology, Inc 1996

Authors and Affiliations

  • Sharon Gregorcyk
    • 1
  • Yuan Kang
    • 1
  • Dörthe Brandt
    • 1
  • Paul Kolm
    • 2
  • Gerry Singer
    • 3
  • Roger R. Perry
    • 1
  1. 1.From the Division of Surgical Oncology, Department of General SurgeryEastern Virginia Medical SchoolNorfolkUSAUSA
  2. 2.Office of BiostatisticsEastern Virginia Medical SchoolNorfolkUSA
  3. 3.Department of PathologyDePaul Medical CenterNorfolkUSA

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