Breast Cancer Research and Treatment

, Volume 49, Issue 1, pp 35–39 | Cite as

Breast carcinoma in women under the age of 50: Relationship between p53 immunostaining, tumour grade, and axillary lymph node status

  • R. Pratap
  • S. Shousha


There is evidence to suggest that breast carcinoma in young women behaves in a more aggressive manner than in older women. As positive immunostaining for p53 has also been associated with increased tumour aggressiveness, this study was aimed at finding out whether patients under the age of 50 years have a higher prevalence of p53 positivity in their tumours. The inter-relationships between age, p53, tumour grade, and axillary lymph node status were also investigated. Two hundred and twenty nine invasive carcinomas were studied. One hundred and eight patients were under the age of 50, and 121 were at or above that age. The specific p53 monoclonal antibody DO7 and the avidin-biotin complex immunoperoxidase technique were used. Fifty seven tumours (25%) showed variable degrees of p53 positivity. The incidence of positivity was slightly higher in women under the age of 50 as compared with those at or above that age (29% (31/108) vs. 21% (26/121), respectively), but the difference was not statistically significant (p < 0.05). On the other hand, in invasive ductal carcinoma (191 cases), p53 positivity was significantly related to high tumour grade (7% in grade I [1/14], 19% in grade II [20/105], and 43% in grade III [31/72]; p < 0.0001 [I–II vs III]). p53 positivity was also significantly related to the presence of extensive (more than three) axillary lymph node metastases (p53 positivity being 22% in node negative tumours [40/178], 18% in tumours with three or less positive nodes [6/33], and 61% in tumours with more than 3 positive nodes [11/18]; p = 0.0033 [second vs third group]). Both features were also significantly more common in the younger age group. The results suggest that the slightly higher incidence of p53 positivity seen in tumours from younger patients, is probably related to the significantly higher incidence of grade III tumours in these patients.

breast carcimoma breast screening p53 tumour grade axillary lymph node metastasis 


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  1. 1.
    Lee CG, McCormick B, Mazumdar M, Vetto B, Borgen PI: Infiltrating breast carcinoma in patients age 30 years and younger: long term outcome for life, relapse, and second primary tumours. Int J Rad Onc Biol Phys 23: 969–975, 1992Google Scholar
  2. 2.
    Calle EE, Martin IM, Thun MJ, Mircale HI, Heath CW Jr: Family history, age and risk of fatal breast cancer. Am J Epidemiol 138: 675–681, 1993PubMedGoogle Scholar
  3. 3.
    De La Rochefordiere A, Asselain B, Campana F, Scholl SM, Fenton J, Vilcoq JR, Durand J-C, Pouillart P, Magdelenat H, Fourquet A: Age as a prognostic factor in premenopausal breast carcinoma. Lancet 341: 1039–1043, 1993CrossRefPubMedGoogle Scholar
  4. 4.
    Iwaya K, Tsuda H, Hiraide H, Tanaki K, Tamakuma S, Fukutomi T, Mukai K, Hirohashi S: Nuclear p53 immunoreaction associated with poor prognosis in breast cancer. Jap J Cancer Res 82: 835–840, 1991Google Scholar
  5. 5.
    Isola J, Viskorpi T, Holli K, Kallioniemi O-P: Association of overexpression of tumor suppressor protein p53 with rapid cell proliferation and poor prognosis in node-negative breast cancer patients. J Nat Cancer Inst 84: 1109–1114, 1992PubMedGoogle Scholar
  6. 6.
    Thor AD, Moore DH II, Edgerton SM, Kawasaki ES, Reithsaus E, Lynch HT, Marcus JN, Schwartz L, Chen L-C, Mayall BH, Smith HS: Accumulation of mutant p53 tumor suppressor gene protein: an index of prognosis in breast carcinoma. J Nat Cancer Inst 84: 845–855, 1992PubMedGoogle Scholar
  7. 7.
    Allred DC, Clark GM, Elledge R, Fuqua SAW, Brown RW, Chamness GC, Osborne CK, McGuire WL: Association of p53 protein expression with tumour cell proliferation rate and clinical outcome in node-negative breast cancer. J Nat Cancer Inst 85: 200–206, 1993PubMedGoogle Scholar
  8. 8.
    Barnes DM, Dublin EA, Fisher CJ, Levison DA, Millis RR: Immunohistochemical detection of p53 protein in mammary carcinoma: an important new indicator of prognosis? Hum Pathol 24: 469–476, 1993CrossRefPubMedGoogle Scholar
  9. 9.
    Norton AJ, Jordan S, Yeomans P: Brief, high-temperature heat denaturation (pressure cooking): a simple and effective method of antigen retrieval for routinely processed tissues. J Pathol 173: 371–379, 1994CrossRefPubMedGoogle Scholar
  10. 10.
    Elston CW, Ellis IO: Pathological prognostic factors in breast cancer. 1. The value of histological grade in breast cancer: experience from a large study with long-term follow up. Histopathology 19: 403–410, 1991PubMedGoogle Scholar
  11. 11.
    Elledge RM, Clark GM, Fuqua SAW, Yu Y-Y, Allred DC: p53 protein accumulation detected by five different antibodies: relationship to prognosis and heat shock protein 70 in breast cancer. Cancer Res 54: 3752–3757, 1994PubMedGoogle Scholar
  12. 12.
    Stenmark-Askmalm M, Stal O, Olsen K, Nordenskjold B, South-East Sweden Breast Cancer Group: p53 as a prognostic factor in stage I breast cancer. Br J Cancer 72: 715–716, 1995PubMedGoogle Scholar
  13. 13.
    Seshadri R, Leong A S-Y, McCaul K, Firgaira FA, Setlur V, Horsfall DJ: Relationship between p53 gene abnormalities and other tumor characteristics in breast-cancer prognosis. Int J Cancer 69: 135–141, 1996PubMedGoogle Scholar
  14. 14.
    Glebov OK, McKenzie KE, White CA, Sukumar S: Frequent p53 gene mutations and novel alleles in familial breast cancer. Cancer Res 54: 3703–3709, 1994PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1998

Authors and Affiliations

  • R. Pratap
    • 1
  • S. Shousha
    • 1
  1. 1.Department of HistopathologyCharing Cross and Westminster Medical SchoolLondonUK

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