Commonly used clinical and morphologic criteria have been reported to be of limited value in predicting the outcome of malignant tumours of the breast. Integrated information from the quantitative analysis in tumour tissue of biological parameters such as oestrogen and progesterone receptors (ER and PGR), proliferative activity, andprotooncogene p53, c-erbB2, and bcl-2 expression, may be useful for defining the biology of growth of breast carcinoma andto plan effective therapeutic strategies.
Patients and methods
Immunohistochemistry with anti-bodies recognizing ER, PGR, Ki-67, and the p53, c-erbB2, and bcl-2 encoded proteins was performed on 291 primary breast carcinomas. Results were integrated with clinicopathological indicators and examined with multivariate statistical procedures and modeling.
Results
P53, c-erbB2, and bcl-2 gene products were detected, respectively, in 30.6%, 31.6%, and 85.9% of the examined invasive breast carcinomas, revealing variable associations with cellular differentiation and proliferation as defined by ER/PGR status, Ki-67, tumour mass and histologic and nuclear grading. A multivariate graphical display on a subset of the most informative cases revealed that bcl-2 expression parallels ER/PGR status and is of importance in separating tumour clusters with different degrees of aggressiveness.
Conclusions
The results of this study indicate that multi-variate explorative analyses conducted on biological and clinico-pathological parameters might constitute an integrated approach to data analysis useful for distinguishing different biological behaviours and therapeutic groups in breast carcinoma. Our findings also suggest that bcl-2 expression may play a pivotal role in tumours lacking ER-mediated growth regulation.
