Prognostic value of p53 for local failure in mastectomy- treated breast cancer patients

Richard C. Zellars, S. G. Hilsenbeck, G. M. Clark, D. C. Allred, T. S. Herman, G. C. Chamness, R. M. Elledge

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Abstract

Purpose: The loss of p53 function is a recognized adverse prognostic factor in invasive breast cancer. Several studies have shown a relationship between the nuclear accumulation of p53 protein (a surrogate marker of p53 inactivation) and poor disease-free and overall survival. In general, however, these studies did not report the prognostic value of p53 for local failure, which we have therefore assessed retrospectively here. Materials and methods: Accumulation of p53 protein was evaluated by immunohistochemistry in 1,530 mastectomy-treated breast cancer patients (259 radiation therapy [RT]- and 1,271 mastectomy only [No RT]-treated patients). Statistical comparisons were made between p53 protein accumulation, estrogen/progesterone receptors, nodal status, tumor size, and local failure rate (LFR). Local failure was defined as tumor recurrence involving the chest wall and/or the ipsilateral supraclavicular/axillary lymph nodes. The median follow-up period was 62 months. Results: In the No RT group, the LFR was 9.1% and 16.5% in p53- negative and p53-positive patients, respectively (P < .001). Multivariate analysis revealed that p53 protein accumulation was significantly associated with an increased risk of local relapse (relative risk [RR], 1.7; 95% confidence interval [CI], 1.2 to 2.4). Nodal status and tumor size were also significant factors. In the RT group, the LFR was 9.3% and 21.5% in p53- negative and p53-positive patients, respectively (P = .009). Multivariate analysis revealed that p53 protein accumulation was significantly associated with an increased risk of local relapse (RR, 2.5; 95% CI, 1.1 to 5.7), as was nodal status. Conclusion: Nuclear accumulation of p53 protein is independently associated with a significantly increased local failure rate in breast cancer patients treated with mastectomy, with or without radiation. (C) 2000 by American Society of Clinical Oncology.

Original languageEnglish (US)
Pages (from-to)1906-1913
Number of pages8
JournalJournal of Clinical Oncology
Volume18
Issue number9
DOIs
Publication statusPublished - May 2000

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Zellars, R. C., Hilsenbeck, S. G., Clark, G. M., Allred, D. C., Herman, T. S., Chamness, G. C., & Elledge, R. M. (2000). Prognostic value of p53 for local failure in mastectomy- treated breast cancer patients. Journal of Clinical Oncology, 18(9), 1906-1913. https://doi.org/10.1200/JCO.2000.18.9.1906