Breast Cancer Research and Treatment

, Volume 152, Issue 3, pp 489–498 | Cite as

Role of epithelial–mesenchymal transition markers in triple-negative breast cancer

  • Sai Yin Cheung
  • Yvonne Jia Yu Boey
  • Valerie Cui Yun Koh
  • Aye Aye Thike
  • Jeffrey Chun Tatt Lim
  • Jabed Iqbal
  • Puay Hoon TanEmail author
Preclinical study


Triple-negative breast cancers (TNBCs) are a heterogeneous group of breast tumours that are often associated with adverse pathological characteristics, poorer clinical outcomes and lack of targeted therapeutic options. Epithelial–mesenchymal transition, which plays a crucial role in tumour development and progression, is characterised by a transition from epithelial to mesenchymal phenotype and loss of proteins involved in maintaining cell junctions. We aimed to correlate protein expression of E-cadherin, Snail2 and transforming growth factor beta (TGF-β) with clinicopathological parameters and survivals of a series of patients with TNBC. The study cohort comprised 767 TNBCs diagnosed at the Department of Pathology, Singapore General Hospital from 1994 to 2012. Immunohistochemistry was performed on sections cut from tissue microarrays using the polymeric method. Staining intensity and percentage of positive tumour cells were evaluated and correlated with clinicopathological findings and clinical outcomes. Loss of E-cadherin expression, Snail2 positivity, cytoplasmic and nuclear expression of TGF-β were observed in 265 (35.2 %), 241 (32.0 %), 272 (36.2 %) and 262 (34.8 %) tumours, respectively. Histological grade significantly correlated with Snail2 positivity (P < 0.001) and loss of membranous E-cadherin expression (P = 0.003). Nuclear expression of TGF-β was inversely correlated with histological grade (P = 0.010). Median follow-up was 73 months, with a maximum of 236 months. Despite a graphical curve for earlier recurrence in patients with tumours harbouring a combinational phenotype of loss of membranous E-cadherin and positive Snail2 expression, there was no statistical significance. Similarly for women with tumours expressing cytoplasmic TGF-β, graphical representation showed poorer metastasis-free survival but without statistical significance. Loss of membranous E-cadherin and positive Snail2 expression are significantly associated with high-grade TNBCs. More work is needed to improve understanding of the role of TGF-β in TNBC.


EMT TNBC Snail2 E-cadherin TGF-β 



This study is part of a research project approved by the SingHealth Centralised Institutional Review Board (CIRB Ref: 2013/664/F) and was funded by the Stratified Medicine Programme Office (Grant No: SMPO201302).

Compliance with Ethical Standards

Conflict of interest



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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Sai Yin Cheung
    • 1
  • Yvonne Jia Yu Boey
    • 2
  • Valerie Cui Yun Koh
    • 3
  • Aye Aye Thike
    • 3
  • Jeffrey Chun Tatt Lim
    • 3
  • Jabed Iqbal
    • 3
    • 4
  • Puay Hoon Tan
    • 2
    • 3
    • 4
    Email author
  1. 1.Department of Clinical PathologyTuen Mun HospitalTuen MunHong Kong
  2. 2.Department of Anatomy, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
  3. 3.Department of PathologySingapore General HospitalSingaporeSingapore
  4. 4.Duke-NUS Graduate Medical School SingaporeSingaporeSingapore

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