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FOXA1 expression after neoadjuvant chemotherapy is a prognostic marker in estrogen receptor-positive breast cancer

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Abstract

Background

Recent studies have indicated that the response to chemotherapy and the prognostic impact of a pathological complete response (pCR) after neoadjuvant chemotherapy differ among breast cancer subtypes. Predictors of response to chemotherapy and prognostic factors for survival might be different in estrogen receptor (ER)-positive breast cancer.

Methods

Women with Stage II to III ER-positive HER2-negative breast cancer treated with anthracycline and taxane-containing neoadjuvant chemotherapy between 2003 and 2011 were retrospectively analyzed. Expression of forkhead box A1 (FOXA1), B cell lymphoma 2 (BCL2) and microtubule-associated protein tau (MAPT) as well as ER, progesterone receptor, HER2 and Ki67 was examined by immunohistochemistry in pre- and post-treatment specimens. Factors predictive of response to neoadjuvant chemotherapy and distant disease-free survival were analyzed.

Results

Tumor grade was positively correlated with Ki67 expression. Expression levels of ER were positively correlated with expression levels of HER2, BCL2, FOXA1 and MAPT in pre-treatment tumors. The Ki67 labeling index was the only factor that was significantly associated with clinical response measured by the reduction of tumor volume and pCR. Lymph node status, expression of ER before neoadjuvant chemotherapy and expression of FOXA1 after neoadjuvant chemotherapy were significantly associated with distant disease-free survival, both by univariate and multivariate analyses.

Conclusions

Patients with ER-positive HER2-negative breast cancer should be selected for neoadjuvant chemotherapy. FOXA1 expression could be a prognostic marker in ER-positive breast cancer.

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Abbreviations

ER:

Estrogen receptor

PgR:

Progesterone receptor

HER2:

Human epidermal growth factor receptor type 2

IHC:

Immunohistochemistry

Ki67 LI:

Ki67 labeling index

BCL2:

B-cell lymphoma 2

FOXA1:

Forkhead box A1

MAPT:

Microtubule-associated protein tau

pCR:

Pathological complete response

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Conflict of interest

All authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Mai Kawase, Tatsuya Toyama, Nobuyasu Yoshimoto, Yumi Endo, Tomoko Asano, Shunzo Kobayashi, Yoshitaka Fujii & Hiroko Yamashita

  2. Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Satoru Takahashi & Shinya Sato

  3. Breast and Endocrine Surgery, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, Sapporo, 060-8648, Japan

    Hiroko Yamashita

Authors
  1. Mai Kawase
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  2. Tatsuya Toyama
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  9. Yoshitaka Fujii
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  10. Hiroko Yamashita
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Corresponding author

Correspondence to Hiroko Yamashita.

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Kawase, M., Toyama, T., Takahashi, S. et al. FOXA1 expression after neoadjuvant chemotherapy is a prognostic marker in estrogen receptor-positive breast cancer. Breast Cancer 22, 308–316 (2015). https://doi.org/10.1007/s12282-013-0482-2

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  • DOI: https://doi.org/10.1007/s12282-013-0482-2

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