Biomarkers and outcome after tamoxifen treatment in node-positive breast cancers from elderly women

M. G. Daidone, A. Luisi, G. Martelli, E. Benini, S. Veneroni, G. Tomasic, G. De Palo, R. Silvestrini

Research output: Contribution to journalArticle

Abstract

The predictive role of tumour proliferative rate and expression of p53, bcl-2 and bax proteins, alone and in association with tumour size, nodal involvement and oestrogen receptors (ER), was analysed on 145 elderly patients (≥ 70 years of age) with histologically assessed node-positive breast cancers treated with radical or conservative surgery plus radiotherapy followed by adjuvant tamoxifen for at least 1 year. The 7-year probability of relapse was significantly higher for patients with tumours rapidly proliferating (hazard ratio (HR) = 2.0, P= 0.01), overexpressing p53 (HR = 4.4, P = 0.0001), weakly or not exhibiting bcl-2 (HR = 1.9, P = 0.02), without ERs (HR = 3.4, P = 0.0001) or with ≥ 4 positive lymph nodes (HR = 2.3, P = 0.003) than for patients with tumours expressing the opposite patho-biological profile. Conversely, tumour size and bax expression failed to influence relapse-free survival. Adjustment for the duration of tamoxifen treatment did not change these findings. Oestrogen receptors, cell proliferation, p53 accumulation and bcl-2 expression were also predictive for overall survival. Within ER-positive tumours, cell proliferation, p53 accumulation, bcl-2 expression and lymph node involvement provided significant and independent information for relapse and, in association, identified subgroups of patients with relapse probabilities of 20% (low-risk group, exhibiting only one unfavourable factor) to 90% (high-risk group, exhibiting three unfavourable factors). Such data could represent the initial framework for a biologically tailored therapy even for elderly patients and highlight the importance of a patho-biological characterization of their breast cancers.

Original languageEnglish
Pages (from-to)270-277
Number of pages8
JournalBritish Journal of Cancer
Volume82
Issue number2
Publication statusPublished - 2000

Keywords

  • bcl-2 expression
  • Cell proliferation
  • Elderly patients
  • Hormone responsiveness
  • Oestrogen receptors
  • p53 expression

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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