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p53 as a Marker of Prognosis in African-American Women with Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

p53 overexpression has been identified as a poor prognostic marker in breast cancer. We investigate the value of p53 status within the context of stage and intrinsic subtype classification (subtype), in a group of African-American (AA) women of lower socioeconomic status (SES) with primary breast cancer.

Methods

Participants were 331 consecutive AA women treated at an urban hospital (median follow-up 41 months) with known subtype [luminal A = estrogen receptor (ER)+ and/or progesterone receptor (PR)+, human epidermal growth factor receptor 2 (HER2)−; luminal B = ER+ and/or PR+, HER2+; HER2+ = ER−, PR−, HER2+; basal = ER−, PR−, HER2−, cytokeratin (CK)5/6+, and/or HER1+; and unclassified = negative for all five markers] and p53 (Pab1801 antibody) immunohistochemical status. Proportional hazards regression models were used to select and evaluate factors prognostic for all-cause mortality.

Results

p53+ status was associated with grade 3 tumors, ER/PR– status, and basal subtype. On univariate analysis, factors related to survival were stage, grade [(3/1) hazard ratio (HR) = 2.64; 95% confidence interval (CI), 1.15–6.07], subtype [(ex. basal/luminal A) HR = 2.15; 95% CI, 1.34–3.45], and p53 status [(+/−) HR = 1.77; 95% CI, 1.15–2.72]. Multivariable modeling indicated that p53+ status remained a negative prognostic factor (HR = 1.63; 95% CI, 1.01–2.59) after adjustment for effects of age, stage, grade, and subtype; 5-year adjusted survival was significantly greater for p53− (66.7%) than p53+ cases (54.7%).

Conclusion

p53 status is an independent predictor of survival after consideration of other strong prognostic factors such as stage, tumor grade, and subtype, and thus may be useful in identifying AA women at high risk of breast cancer mortality.

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Acknowledgment

The authors acknowledge the following sources of support: CFMUP, Chicago, IL and Division of Cancer Prevention, NCI/NIH, Bethesda, MD.

Author information

Authors and Affiliations

  1. The Cancer Foundation for Minority and Underserved Populations, Chicago, IL, USA

    Keith A. Dookeran MBBS, FRCS(Ed), MD, MBA

  2. Department of Health Studies, University of Chicago, Chicago, IL, USA

    James J. Dignam PhD

  3. Department of Pathology, Stroger Hospital of Cook County, Chicago, IL, USA

    Karen Ferrer MD & Marin Sekosan MD

  4. Division of Cancer Prevention, NCI, Bethesda, MD, USA

    Worta McCaskill-Stevens MD

  5. Center for Health Disparities Research, University of Chicago, Chicago, IL, USA

    Sarah Gehlert PhD

Authors
  1. Keith A. Dookeran MBBS, FRCS(Ed), MD, MBA
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  2. James J. Dignam PhD
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  3. Karen Ferrer MD
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  4. Marin Sekosan MD
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  5. Worta McCaskill-Stevens MD
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  6. Sarah Gehlert PhD
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Corresponding author

Correspondence to Keith A. Dookeran MBBS, FRCS(Ed), MD, MBA.

Additional information

Prior scientific presentations and abstracts:

American Society of Clinical Oncology, Breast Cancer Symposium: 2008 (in part). American Society of Clinical Oncology, Annual Meetings: 2006, 2008, 2009 (in part). American Association of Cancer Research, Annual Meetings: 2006, 2007 (in part).

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Dookeran, K.A., Dignam, J.J., Ferrer, K. et al. p53 as a Marker of Prognosis in African-American Women with Breast Cancer. Ann Surg Oncol 17, 1398–1405 (2010). https://doi.org/10.1245/s10434-009-0889-3

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  • DOI: https://doi.org/10.1245/s10434-009-0889-3

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