Title: Clinicopathological Correlates, with Special Reference to Hormone Receptors

Authors: Dr Sunitha Balakrishnan, Dr Babu K Joseph, Dr Freena Rose

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.04

Abstract

B – cell lymphoma 2 (Bcl-2) is an antiapoptotic protein belongs to Bcl2 family. It is an important breast cancer prognostic marker. Bcl2 is upregulated by estrogen in breast cancer. Therefore, Bcl2 expression in breast cancer can be considered as a sign of estrogen functional activity.

Aim: To evaluate the expression of Bcl-2 oncoprotein in patients with infiltrating duct carcinoma, breast –NOS (IDC-NOS) and to assess its correlation with various clinicopathological variables, especially hormone receptors.

Materials & Methods: 75 cases of infiltrating duct carcinoma breast, with defined ER, PR & Her2 status were retrieved & immunohistochemical analysis with Bcl2 was done. Clinicopathological features were analyzed and correlation between Bcl2 expression and the above features especially hormone status were assessed.

Results & Conclusion: 43 (57.3%) cases of IDC – NOS showed Bcl-2 positivity. Bcl2 expression was significantly associated with lower histological grade and hormone receptor positivity. Triple negative breast carcinoma (TNBC) show lack of expression of Bcl-2 in significant proportion.

Keywords: Infiltrating duct carcinoma breast, Bcl-2 Expression, hormone receptors.

 

References

  1. Tsujimoto, y.& Gorham, j., Cossman, j.,Jaffe, e. & Croce, c.m. (1985). The t (14; 18) chromosome translocations involved in B-cell neoplasms result from mistakes in VDJ joining. Science, 299, 1390-1393.
  2. Hockenbery, d., Nunez, g., Milliman, c., Schreiber, r.d. & Korsmeyer, s.j. (1990). Bcl-2 is an inner mitochondrial membrane protein that blocks programmed cell death. Nature, 348, 334-336.
  3. Bargou RC, Daniel PT, Mapara MY, et al. Expression of the bcl-2 gene family in normal and malignant breast tissue: low bax-(alpha) expression in tumor cells correlates with resistance towards apoptosis. Int J Cancer 1995;60:854-859.
  4. Visscher DW, Sarkar F, Tabaczka P, et al Clinicopathologic analysis of bcl-2 immunostaining in breast carcinoma. Mod Pathol 1996;9:642-646.
  5. Hellemans P, van Dam PA, Weyler J, et al. Prognostic value ofbcl-2 expression in invasive breast cancer. Br J Cancer 1995;72:354-360.
  6. Bozzetti C, Nizzoli R, Naldi N, et al. Bcl2 expression on fine needle aspirates from primary breast carcinoma – Correlation with other biological factors . Ca. Cytopathol. 1999;87(4):224-230
  7. Hun Lee K , Ah Im S , Youn Oh D, et al. Prognostic significance of Bcl-2 expression in stage III breast cancer patients who had received doxorubicin and cyclophosphamide followed by paclitaxel as adjuvant chemotherapy. BMC Cancer 2007: 7; 63-70
  8. Bhargava V, Kell DL, van de Rijn M, et al. Bcl-2 immunoreactivity in breast carci-noma correlates with hormone receptor positivity. Am J Pathol1994;145:535-540.
  9. Linke S P , Bremer T M , Herold C D et al. A multimarker model to predict outcome in tamoxifen treated breast cancer patients . Clin Ca. Res 2006;15:1175-1183
  10. Park SH, Kim H, Song BJ. Down regulation of bcl2 expression in inva­sive ductal carcinomas is both estrogen- and progesterone-receptor de­pendent and associated with poor prognostic factors. Pathol Oncol Res 2002;8:26-30.
  11. Seong MK, Lee JY, Byeon J, Sohn YJ, Seol H, Lee JK, et al. Bcl-2 is a highly significant prognostic marker of hormone-receptor-positive, hu­man epidermal growth factor receptor-2-negative breast cancer. Breast Cancer Res Treat 2015;150:141-8.
  12. Callagy GM, Pharoah PD, Pinder SE, Hsu FD, Nielsen TO, Ragaz J, et al. Bcl-2 is a prognostic marker in breast cancer indepe-ndently of the Nottingham Prognostic Index. Clin Cancer Res 2006;12:2468-75.
  13. Chen H.W.,su W.C., Guo h. et al. p53 and c-erbB-2 but not bcl-2 are predictive of metastasis free survival in breast cancer patients receiving post-mastectomy adjuvant radiotherapy in Taiwan. Japan. J. Clin. Oncol. 2002;32:332-339
  14. Callagy GM, Webber MJ, Pharoah PD, Caldas C. Met-analysis confirm BCL2 is an independent prognostic marker in breast cancer. BMC Cancer. 2008;8:153
  15. Le MG, Mathieu M-C, Douc-Rasy S, et al. c-myc, p53 and bcl-2, Apoptosis-related genes in infiltrating breast carcinomas: Evidence of a link between bcl-2 protein over-expression and a lower risk of metastasis and death in operable patients. Int J Cancer. 1999;84:562–7.
  16. Gee JM, Robertson JRR, Ellis IO. Immunocytochemical localization of Bcl-2 protien in human breast cancers and its relationship to a series of prognostic markers and response to endocrine therapy. Int J Cancer. 2006;5:619–28.
  17. Leek RD, Kaldam.anis L, Pezzella F, et al. bcl-2 in normal human breast and carcinoma, association with oestrogen receptor-positive, epidermal growth factor receptor-negative tumours and in situ cancer. Br J Cancer 1994;69:135-139.
  18. Chen LY, Tsang JY, Ni YB, Chan SK,Chan KF, Zhang s,et al. Bcl2 and ki 67 refine prognostication in luminal breast cancers. Breast Cancer Res Treat2015; 149:631-43

Corresponding Author

Dr Babu K Joseph

Assistant Professor, Department of Pediatrics,

Govt. Medical College, Thrissur, Kerala, PIN -680596

Phone -9446051832, 0487- 2204832, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.