Objective: To assess the prognostic significance and impact of p53 protein and human epidermal growth factor receptor 2 (HER2) overexpression on 5-year survival in young patients with stage II breast cancer (aged less than 50 years).
Material and methods: Material from medical records and archived tumor tissues from 34 young women diagnosed with stage II breast cancer and obtained between 2001 and 2003 was analyzed retrospectively. Twelve (35%) patients died from breast cancer. Using archived tumor tissues, p53 protein and HER2 over-expression was determined immunohistochemically. Using medical records, and adjuvant chemotherapy, adequacy of anthracycline dose, and hormonotherapy administered for the patients were analyzed.
Results: p53 protein and HER2 overexpression was documented in 20.6% and 26.4% of women, respectively. Kaplan-Meier survival analysis showed that patients with tumors positive for p53 protein and negative estrogen receptors, and treated with an inadequate dose of anthracyclines died within shorter period after diagnosis (log-rank P=0.016, log-rank P=0.027, log-rank P=0.013, respectively). There were no significant associations between HER2 overexpression and 5-year survival in this population (log-rank P=0.51). Multivariate analysis revealed that an inadequate dose of anthracyclines (P=0.028) was the only independent factor for poor outcome.
Conclusions: p53 protein overexpression, negative estrogen receptors in tissue samples, and inadequate chemotherapy with anthracyclines were associated with reduced overall survival in young women with stage II breast cancer. Inadequate adjuvant therapy with anthracyclines was the only independent prognostic factor.