pISSN 1738-6756   eISSN 2092-9900
Open Access, Peer-reviewed
    J Breast Cancer. 2011 Feb;14(Suppl 1):S10-S16. Korean.
    Published online Feb 28, 2011.
    https://doi.org/10.4048/jbc.2011.14.S.S10
    Copyright © 2011 Korean Breast Cancer Society
    Original Article

    Different Prognostic Significance of Bcl-2 Based on Cancer Molecular Subtype

    Ju-Young Lee, Hyun-Ah Kim, Eun-Kyu Kim, Hoe-Min Yang, Kwan-il Kim, Jong Inn Lee, Jae Soo Koh,1 Eunyoung Ko,2 Nan Mo Moon,2 Min-Suk Kim,3 Nam-Sun Paik,4 and Woo Chul Noh
      • Department of Surgery, Korea Institute of Radiological & Medical Sciences, Korea Cancer Center Hospital, Seoul, Korea.
      • 1Department of Pathology, Korea Institute of Radiological & Medical Sciences, Korea Cancer Center Hospital, Seoul, Korea.
      • 2Department of Surgery, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea.
      • 3Department of Pathology, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea.
      • 4Department of Surgery, Konkuk University College of Medicine, Seoul, Korea.
    • Correspondence: Email: nohwoo@kcch.re.kr
    Received October 29, 2010; Accepted February 14, 2011.

    Abstract

    Purpose

    B-cell lymphoma (bcl)-2 is an anti-apoptotic gene, and it is a poor prognostic factor in various malignant tumors. However, the prognostic significance of bcl-2 expression in breast cancer remains controversial. We investigated the prognostic significance of bcl-2 according to cancer molecular subtype.

    Methods

    We analyzed 411 patients with primary invasive breast cancer who underwent surgery at our institution between 1999 and 2001. The subtypes were classified as luminal (estrogen receptor [ER]+ and/or progesterone receptor [PR]+, irrespective of human epidermal factor receptor 2 [HER2]), triple-negative (ER-, PR-, and HER2-), or HER2 (ER- ,PR-, and HER2+).

    Results

    A total of 236 (57.4%) cases were positive for bcl-2, and bcl-2 expression was significantly associated with earlier stage, lower grade, expression of hormone receptor positivity, and HER2 negativity. No difference in disease-free survival (DFS) was observed based on bcl-2 expression. However, the prognostic significance of bcl-2 varied with subtype; bcl-2 was not a prognosticator in patients with the luminal and HER2 subtypes. However, patients with bcl-2(+) tumors of the triple-negative subtype showed significantly worse DFS than those with bcl-2(-) tumors (p=0.048). In a multivariate analysis, bcl-2 expression remained a significant predictor of recurrence in patients with the triple-negative subtype (hazard ratio, 3.26; 95% confidence interval, 1.40-7.59; p=0.006).

    Conclusion

    The prognostic significance of bcl-2 varied with molecular subtype; bcl-2 expression was a poor prognosticator in patients with the triple-negative subtype, but not in those with the luminal and HER2 subtypes.

    Keywords
    Bcl-2; Breast neoplasms; Disease-free survival; Prognosis; Triple negative breast cancer

    Figures

    Figure 1
    Disease-free survival according to bcl-2 expression (A) and disease free survival according to hormonal receptor expression (B).

    Figure 2
    Disease-free survival according to bcl-2 expression in hormonal receptor positive breast cancer (A), in HER2 positive breast cancer (B), in triple negative breast cancer (C).

    Tables

    Table 1
    Clinicopathologic characteristic and treatment details of patients

    Table 2
    Clinicopathologic characteristic according to bcl-2 expression

    Table 3
    Clinicopathologic characteristic of triple negative breast cancer patients according to bcl-2 expression

    Table 4
    Univariated analysis of factors associated with disease-free survival in triple negative breast cancer

    Table 5
    Multivariated analysis of factors associated with disease-free survival in triple negative breast cancer

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    MeSH Terms
    Breast Neoplasms
    Humans
    Metrics
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