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Impact of GATA-3 and FOXA1 expression in patients with hormone receptor-positive/HER2-negative breast cancer

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Abstract

Background

Determining the indications for adjuvant chemotherapy (CT) in patients with hormone receptor (HR)-positive/HER2-negative breast cancer are difficult. The transcription factors GATA-binding protein 3 (GATA-3) and Forkhead-box protein A1 (FOXA1) are crucial for the hormone responsive phenotype of breast cancer. This study evaluated whether the expression of GATA-3 and FOXA1 is a prognostic and predictive marker of outcomes in patients with HR-positive/HER2-negative breast cancer.

Methods

The expression of GATA-3 and FOXA1 was analyzed immunohistochemically in 214 patients with invasive breast cancer to evaluate the association with the clinicopathological features and the prognosis.

Results

GATA-3 expression was positively correlated with FOXA1 expression (P < 0.0001). Both GATA-3 and FOXA1 were positively correlated with ER (P < 0.0001 each) and PR expression (P = 0.0001 and P = 0.0009, respectively), and inversely correlated with nuclear grade (P = 0.0002 and P = 0.0018, respectively) and Ki67 index (P = 0.0052 and P = 0.0049, respectively). Expression of GATA-3 and FOXA1 was associated with better prognosis. FOXA1 was an independent favorable prognostic marker in HR-positive/HER2-negative breast cancer. Disease-free survival rates were similar in patients with HR-positive/HER2-negative breast cancer and high FOXA1 expression given adjuvant hormone therapy (HT) alone and those given CT plus HT.

Conclusion

GATA-3 and FOXA1 are associated with a less aggressive phenotype and a better prognosis in patients with HR-positive/HER2-negative breast cancer. FOXA1 may be useful in identifying those patients who may not require adjuvant CT.

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Acknowledgments

This study was supported by grants from the Ministry of Education, Culture, Sports Science, and Technology of Japan (Grant No. 23591896). We are grateful to Ms. Yuko Kubota for her valuable technical assistance.

Conflict of interest

The authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan

    Yuichi Hisamatsu, Eriko Tokunaga, Nami Yamashita, Sayuri Akiyoshi, Satoko Okada, Yuichiro Nakashima, Kenji Taketani, Masaru Morita & Yoshihiko Maehara

  2. Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Shinichi Aishima & Yoshinao Oda

Authors
  1. Yuichi Hisamatsu
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  2. Eriko Tokunaga
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  4. Sayuri Akiyoshi
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  10. Masaru Morita
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  11. Yoshihiko Maehara
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Corresponding author

Correspondence to Eriko Tokunaga.

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Hisamatsu, Y., Tokunaga, E., Yamashita, N. et al. Impact of GATA-3 and FOXA1 expression in patients with hormone receptor-positive/HER2-negative breast cancer. Breast Cancer 22, 520–528 (2015). https://doi.org/10.1007/s12282-013-0515-x

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  • DOI: https://doi.org/10.1007/s12282-013-0515-x

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