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Impact of FOXA1 Expression on the Prognosis of Patients with Hormone Receptor-Positive Breast Cancer

Annals of Surgical Oncology volume 19, pages 1145–1152 (2012)Cite this article

Abstract

Background

Assessing indications for adjuvant chemotherapy (CT) in patients with hormone receptor (HR)-positive/human epidermal receptor 2 (HER2)-negative breast cancer remains a challenge for oncologists. In this study, we evaluated whether forkhead-box protein A1 (FOXA1) expression was a prognostic and predictive marker for HR-positive breast cancer.

Methods

FOXA1 expression was analyzed immunohistochemically in 239 primary breast cancers. Associations between FOXA1 expression and clinicopathological characteristics and prognosis were evaluated.

Results

FOXA1 expression was positively correlated with estrogen receptor (ER) (P < 0.0001) and progesterone receptor (PR) expression (P = 0.0011), and inversely correlated with nuclear grade (P = 0.0048) and Ki67 index (P = 0.0112). High FOXA1 was associated with longer recurrence-free survival (RFS) in all cases (P < 0.0001) and in ER-positive cases (P < 0.0001), but not in ER-negative cases. In addition, FOXA1 expression was associated with good prognosis, regardless of the Ki67 index, in HR-positive cases. FOXA1 was an independent prognostic factor on multivariate analysis in all cases and in ER-positive cases. Among HR-positive/HER2-negative cases with high FOXA1 expression, there was no difference in RFS between those given hormone therapy (HT) alone and those given CT plus HT.

Conclusions

In HR-positive breast cancer, FOXA1 expression was significantly associated with good prognosis. FOXA1 expression may be a useful marker for HR-positive/HER2-negative breast cancer to identify patients with good prognosis who may not require CT.

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Affiliations

  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yuichi Hisamatsu MD, Eriko Tokunaga MD, PhD, Nami Yamashita MD, Sayuri Akiyoshi MD, Satoko Okada MD, Yuichiro Nakashima MD, Masaru Morita MD, PhD, Yoshihiro Kakeji MD, PhD & Yoshihiko Maehara MD, PhD

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

    Shinichi Aishima MD, PhD

Authors
  1. Yuichi Hisamatsu MD
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  2. Eriko Tokunaga MD, PhD
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  3. Nami Yamashita MD
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  4. Sayuri Akiyoshi MD
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  5. Satoko Okada MD
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  6. Yuichiro Nakashima MD
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  7. Shinichi Aishima MD, PhD
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  8. Masaru Morita MD, PhD
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  9. Yoshihiro Kakeji MD, PhD
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  10. Yoshihiko Maehara MD, PhD
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Corresponding author

Correspondence to Eriko Tokunaga MD, PhD.

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Hisamatsu, Y., Tokunaga, E., Yamashita, N. et al. Impact of FOXA1 Expression on the Prognosis of Patients with Hormone Receptor-Positive Breast Cancer. Ann Surg Oncol 19, 1145–1152 (2012). https://doi.org/10.1245/s10434-011-2094-4

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  • DOI: https://doi.org/10.1245/s10434-011-2094-4

Keywords

  • Breast Cancer
  • Estrogen Receptor
  • Hormone Therapy
  • Progesterone Receptor
  • Ki67 Index