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p-Glycoprotein expression as a predictor of breast cancer recurrence

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Abstract

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.

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Authors and Affiliations

  1. From the Division of Surgical Oncology, Department of General Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA, USA

    Sharon Gregorcyk MD, Yuan Kang MD, PhD, Dörthe Brandt MD &  Roger R. Perry MD

  2. Office of Biostatistics, Eastern Virginia Medical School, Norfolk, Virginia, USA

    Paul Kolm PhD

  3. Department of Pathology, DePaul Medical Center, Norfolk, Virginia, USA

    Gerry Singer MD

Authors
  1. Sharon Gregorcyk MD
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  2. Yuan Kang MD, PhD
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  3. Dörthe Brandt MD
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  4. Paul Kolm PhD
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  5. Gerry Singer MD
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  6. Roger R. Perry MD
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Gregorcyk, S., Kang, Y., Brandt, D. et al. p-Glycoprotein expression as a predictor of breast cancer recurrence. Annals of Surgical Oncology 3, 8–14 (1996). https://doi.org/10.1007/BF02409045

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  • DOI: https://doi.org/10.1007/BF02409045

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