Skip to main content
SpringerLink
Log in

p53 expression is a factor for prognostic assessment in breast sarcoma

  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

The present study was undertaken with the aim of evaluating the clinical and anatomopathological findings, emphasizing expression of the protein p53 as possible prognostic markers, in patients with breast sarcoma. p53 immunohistochemical expression was determined in archival paraffin embedded tissue blocks of 30 breast sarcoma patients, (19 fibrosarcomas, nine malignant fibrohistiocytomas and two liposarcomas) treated at the Hospital do Câncer AC Camargo, São Paulo, Brazil from 1955 to 1990. Immunopositivity was present in 50% of the cases. The survival of the patients was compared with the above parameters. Median follow up time was 113 months. The 5 years specific survival rates were 55.1% for patients with a positive expression of p53 contrariwise to 92.3% of specific survival found in p53 negative patients (p = 0.04). Positive expression of p53 was found in 3/4 (75%) of the patients with local recurrence and in 7/9 (77%) of patients with metastatic disease. No significant correlation between survival and clinicopathologic features (age, menopausal status, tumor size, stage and histological type), was found. A slight positive correlation between high grade and poor outcome was observed, 89% of the metastatic cases being classified as high grade (p = 0.02, by one sided Fisher's exact test). When we have compared, independently, survival probability curves between p53 positive/negative expression and each category of clinicopathologic features a worse prognosis was observed when p53 was positive in patients older than 50 years (p = 0.01), in tumors larger than 5 cm (p = 0.02), within the malignant fibrous histiocytoma subtype (p = 0.01) and in tumors classified as high grade (p = 0.07). In conclusion p53 expression seems to be a useful prognostic marker for this type of tumor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Moore MP, Kinne DW: Breast sarcoma. Surg Clin N Am 76: 383–393, 1996

    Google Scholar 

  2. Terrier P, Terrier-Lacombe M, Mouriesse H, Friedman S, Spielmann M, Contesso G: Primary breast sarcoma: a review of 33 cases with immunohistochemistry and prognostic factors. Breast Cancer Res Treat 13: 39–48, 1989

    Google Scholar 

  3. Ciatto S, Bonardi R, Cataliotti L, Cardona G: Sarcomas of the breast: a mullticenter series of 70 cases. Neoplasma 39: 375–379, 1992

    Google Scholar 

  4. McGregor GI, Knowling MA, Este FA: Sarcoma and cystosarcoma phyllodes tumors of the breast – a retrospective review of 58 cases. Am J Surg 167: 477–480, 1994

    Google Scholar 

  5. McGowan TS, Cummings BJ, O'sulivan B, Miller N, Panzarella T: An analysis of 78 breast sarcoma patients without distant metastases at presentation. I. J Rad Oncol 46: 383–390, 2000

    Google Scholar 

  6. Norris HJ, Taylor HB: Sarcomas and related mesenchymal tumors of the breast. Cancer 22: 22–28, 1968

    Google Scholar 

  7. Callery CD, Rosen PP, Kinne DW: Sarcoma of the breast: a study of 32 patients with reappraisal of classification and therapy. Ann Surg 201: 527–532, 1985

    Google Scholar 

  8. Berg JW, DeCrosse JJ, Fracchia AA, Farrow J: Stromal sarcomas of the breast: a unified approach to connective tissue sarcomas other than cystosarcoma phyllodes. Cancer 15: 418–424, 1962

    Google Scholar 

  9. Barnes L, Pietruszka M: Sarcomas of the breast: a clinicopathologic analysis of ten cases. Cancer 40: 1577–1585, 1977

    Google Scholar 

  10. Smola MG, Ratschek M, Amann W, Samonigg H, Mayers R: The impact of resection margins in the treatment of primary sarcomas of the breast: a clinicopathological study of 8 cases with review of literature. Eur J Surg Oncol 19: 61–69, 1993

    Google Scholar 

  11. Gaynor JJ, Tan CC, Casper, ES, Collin CF, Friedrich C, Siu M, Hajdu SI, Brennan MF: Refinement of clinicopathologic staging for localized soft tissue sarcoma of the extremity, a study of 423 adults. J Clin Oncol. 10: 1317–1329, 1992

    Google Scholar 

  12. Hadju SI, D'ambrosio FG: Histopathologic classificaton of limb sarcomas in relation to prognosis. Surg Oncol Clin North Am 2: 509–535, 1993

    Google Scholar 

  13. Jones MW, Norris HJ, Wargotz ES, Weiss SW: Fibrosarcomamalignant fibrous histiocytoma of the breast. Am J Surg Pathol 16: 667–674, 1992

    Google Scholar 

  14. Spielmann M, Zelek L, Llombart A: Mesenchymal breast sarcomas: general review. Arch Anat Cytol Pathol 43: 73–76, 1995

    Google Scholar 

  15. Collin CF, Friedrich C, Godbold J, Hadju S, Brennan MF: Prognostic factors for local recurrence and survival in patients with localized extremity soft-tissue sarcoma. Semin Surg Oncol 4: 30–37, 1988

    Google Scholar 

  16. Alho A, Alvegard TA, Berlin O, Ranstam J, Rydholm A, Rooser B, Stener B: Surgical margin in soft tissue sarcoma. The Scandinavian sarcoma group experience. Acta Orthop Scand 60: 687–692, 1989

    Google Scholar 

  17. North JH, McPhee M, Arredondo M, Edge SB: Sarcoma of the breast: implications of the extent of local therapy. Am Surg 64: 1059–1061, 1998

    Google Scholar 

  18. Guttman H, Pollock RE, Ross MI, Benjamin RS, Johnston DA, Janjan NA, Romsdahl MM: Sarcoma of the breast: implications for extent of therapy. Surgery 116: 505–509, 1994

    Google Scholar 

  19. Barrow BJ, Janjan NA, Gutman H, Benjamin RS, Allen P, Romsdahl MN, Ross MI, Pollock RE: Role of radiotherapy in sarcoma of the breast-a retrospective review of the M – D Anderson experience. Radiother Oncol 52: 173–178, 1999

    Google Scholar 

  20. Fawcett FJ: Sarcoma of the breast. Br J Cancer 21: 285–294, 1966

    Google Scholar 

  21. Toguchida J, Yamaguchi T, Dayton SH, Beauchamp RL, Herrera GE, Ishizaki K, Yamamuro T, Meyers PA, Little JB, Sasaki MS, Weichselbaum RR, Yandell DW: Prevalence and spectrum of germline mutations of the p53 gene among patients with sarcoma. N Engl J Med 326: 1301–1308, 1992

    Google Scholar 

  22. Andreassen Å, Øyjord T, Hovig E, Holm R, Flørenes VA, Nesland JM, Myklebost O, Høie J, Bruland ØS, Ørresen AL, Fodstad Ø: p53 abnormalities in different subtypes of human sarcomas. Cancer Res 53: 468–471, 1993

    Google Scholar 

  23. Taubert H, Wurl P, Meye A, Berger D, Thamm B, Neumann K, Hinze R, Schimidt H, Rath FW: Molecular and immunohistochemical p53 status in liposarcoma and malignant fibrous histiocytoma. Cancer 76: 1187–1196, 1995

    Google Scholar 

  24. Yoo J, Lee HK, Kang CS, Park WS, Lee JY, Shim SI: p53 gene mutations and protein expression in human soft tissue sarcomas. Arch Pathol Lab Med 121: 395–399, 1997

    Google Scholar 

  25. Rieske P, Bartkowiak JK, Szadowska AM, Olborski B, Harezga-Bal B, Debiec-Rychter M: A comparative study of p53/MDM2 genes alterations and p53/MDM2 proteins immunoreactivity in soft-tissue sarcomas. J Exp Cancer Res 18: 403–416, 1999

    Google Scholar 

  26. Leach FS, Tokino T, Meltzer P, Burrell M, Oliner JD, Smith S, Hill DE, Sidransky D, Kinzler KW, Vogelstin B: p53 mutation and MDM2 amplification in human soft tissue sarcomas. Cancer Res 53: 2231–2234, 1993

    Google Scholar 

  27. Cordon-Cardo C, Latres E, Drobnjak M, Oliva MR, Pollack D, Woodruff JM, Marechal V, Chen J, Brennan MF, Levine AJ: Molecular abnormalities of mdm2 and p53 genes in adult soft tissue sarcomas. Cancer Res 54: 749–755, 1994

    Google Scholar 

  28. Drobnjak M, Latres E, Pollack D, Karpeh M, Dudas M, Woodruff JM, Brennan MF, Cordon-Cardo C: Prognostic implications of p53 nuclear overexpression and high proliferation index of Ki-67 in adult soft-tissue sarcomas. J Natl Cancer Inst 86: 549–554, 1994

    Google Scholar 

  29. Kawai A, Noguchi M, Beppu Y, Yokoyama R, Mukai K, Hirohashi S, Inoue H, Fukuma H: Nuclear immunoreaction of p53 protein in soft tissue sarcomas: a possible prognostic factor. Cancer 73: 2499–2505, 1994

    Google Scholar 

  30. Latres E, Drobnjak M, Pollack D, Oliva MR, Ramos M, Karpeh M, Woodruff JM, Cordon-Caro C: Chromosome 17 abnormalities and TP 53 mutations in adult soft tissue sarcomas. Am J Pathol 145: 345–355, 1994

    Google Scholar 

  31. Hieken TJ, Das Gupta TK: Mutant p53 expression, a marker of diminished survival in well-differentiated soft tissue sarcoma. Clin Can Res 2: 1391–1395, 1996

    Google Scholar 

  32. Konomoto T, Hayashi K, Kumazawa J, Tsuneyoshi M: Leyomiosarcoma in soft tissue: examination of p53 status and cell proliferating factors in different locations. Hum Pathol 29: 74–81, 1998

    Google Scholar 

  33. Taubert H, Wurl P, Bache M, Meye A, Berger D, Holzhausen HJ, Hinze R, Schimidt H, Rath FW: The p53 gene in soft tisssue sarcomas: prognostic value of DNA sequencing versus immunohistochemistry. Anticancer Res 18: 183–188, 1998

    Google Scholar 

  34. Schneider-Stock R, Ziegeler A, Haeckel C, Franke DS, Rys J, Roessner A: Prognostic relevance of p53 alterations and Mib-1 proliferation index in subgroups of primary liposarcomas. Clin Cancer Res 5: 2830–2835, 1999

    Google Scholar 

  35. Würl P, Taubert H, Meye A, Berger D, Lautenschläger C, Holzhausen HJ, Schimidt H, Kalthoff H, Rath FW, Dralle H: Prognostic value of immunohistochemistry for p53 in primary soft-tissue sarcomas: a multivariate analysis of five antibodies. J Cancer Res Clin Oncol 123: 502–508, 1997

    Google Scholar 

  36. Würl P, Meye A, Lautenschläger C, Schimidt H, Bache M, Kalthoff H, Schönfelder M, Rath FW, Taubert H: Clinical relevance of pRb and 53 co-overexpression in soft-tissue sarcomas. Cancer Lett 139: 159–165, 1999

    Google Scholar 

  37. Bears O, Henson D, Hutter R, Kennedy B (eds): Manual for Staging of Cancer. Soft Tissue Sarcomas. 4th edn, American Joint Committee Cancer, J.B. Lippincott, Philadelphia, 1992

  38. Tavassoli A: Pathology of the Breast. Mesenchymal Lesionssarcomas. Appleton & Lance, Norwalk, 1992, pp 539–560

    Google Scholar 

  39. Kaplan EL, Meier P: Non parametric estimation from incomplete observations. J Am Stat Assoc 53: 457–481, 1958

    Google Scholar 

  40. Oberman HA: Sarcomas of the breast. Cancer 18: 1233–1243, 1965

    Google Scholar 

  41. Pollard SG, Marks PV, Temple LN, Thompson HH: Breast sarcoma: a clinicopathological review of 25 cases. Cancer 66: 941–944, 1990

    Google Scholar 

  42. Tomlinson J, Barsky SH, Nelson S, Singer S, Pezeshki B, Lee MC, Eilber F, Nguyen M: Different patterns of angiogenesis in sarcomas and carcinomas. Clin Cancer Res 5: 3516–3522, 1999

    Google Scholar 

  43. Wang J, Coltrera MD, Gown AM: Abnormalities of p53 and p110Rb tumor supressor gene expression in human soft tisue tumors: correlations with cell proliferation and tumor grade. Modern Pathol 8(8): 837–842, 1995

    Google Scholar 

  44. Nakanishi H, Ohsawa M, Naka N, Uchida A, Ochi T, Aozasa K: Immunohistochemical detection of bcl-2 and p53 proteins and apoptosis in soft tissue sarcoma: their correlation with prognosis. Oncology 54: 238–244, 1997

    Google Scholar 

  45. Ohsawa M, Aozasa K, Myoui A, Fujita MQ, Tsujimoto M, Ueda T, Uchida A, Ono K, Matsumoto K: Histological factors contributing to favorable prognoses of soft tissue sarcomas in premenopausal patients. Jpn J Clin Oncol 21: 115–119, 1991

    Google Scholar 

  46. Bergh P, Meis-Kindblom JM, Gherlinzoni F, Berlin O, Bachini P, Bertoni F, Gunterberg B, Kindblom L-G: Synovial sarcoma: identification of low and high risk groups. Cancer 85: 2596–2607, 1999

    Google Scholar 

  47. Bonsing BA, Corver WE, Gorsira MC, Vliet MV, Oud PS, Cornelisse CJ, Fleuren GJ: Specificity of seven monoclonal antibodies against p53 evaluated with western blotting, immunohistochemistry, confocal laser scanning microscopy and flow cytometry. Cytometry 28: 11–24, 1997

    Google Scholar 

  48. Furuwatari C, Yagi A, Yamagami O, Ishikawa M, Hidaka E, Ueno I, Furihata K, Ogiso Y, Katsuyama T: A comprehensive system to explore p53 mutations. Am J Clin Pathol 110: 368–373, 1998

    Google Scholar 

  49. Reid AH, Tsai MM, Venzon DJ, Wright CF, Lack EE, O'leary TJ: MDM2 amplification, p53 mutation, and accumulation of the p53 gene product in malignant fibrous histiocytoma. Diagn Mol Pathol 5: 65–73, 1996

    Google Scholar 

  50. Feakins RM, Mulcahy HE, Nickols CD, Wells CA: p53 expression in phyllodes tumours is associated with histological features of malignancy but does not predict outcome. Histopathology 35: 162–169, 1995

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hospital do Câncer AC Camargo, Brazil

    Maria do Socorro Maciel, Inês N. Nishimoto, Fauzer S. Abrão & Mário Mourão Neto

  2. Hospital das Clínicas da Faculdade de Medicina da USP, Brazil

    Leda C. Viegas

  3. Institituto Adolpho Lutz, Brazil

    Suely Nonogaki

  4. Departamento de Radiologia da Faculdade de Medicina da USP, Disciplina de Oncologia, São Paulo, Brasil

    M. Mitzi Brentani

Authors
  1. Maria do Socorro Maciel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Leda C. Viegas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Suely Nonogaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Inês N. Nishimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fauzer S. Abrão
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mário Mourão Neto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Mitzi Brentani
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Maciel, M.d.S., Viegas, L.C., Nonogaki, S. et al. p53 expression is a factor for prognostic assessment in breast sarcoma. Breast Cancer Res Treat 71, 193–202 (2002). https://doi.org/10.1023/A:1014403613747

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1014403613747

Search

Navigation