Evaluation of forkhead-box C1 expression in breast cancer: Prognostic value and histopathological correlations in Egyptian women

Abstract

Background Forkhead box C1 (FOXC1) is considered an important member of forkhead-box transcription factors. Previous studies have shown that FOXC1 is associated with tumor progression and represents a poor prognostic indicator in triple-negative basal-like breast cancer. Method This is a retrospective study conducted on 187 cases of invasive breast carcinoma obtained from Histopathology Laboratory in Oncology Center, Faculty of Medicine, Mansoura University, starting from 2012. Aim and objectives In this study, we aimed to study FOXC1 protein expression in molecular subtypes of breast cancer and to correlate its expression with other prognostic parameters using immunohistochemistry and tissue microarrays. Results FOXC1-positive expression was seen in 26.7% of cases. Positive FOXC1 expression was most common in triple-negative basal-like breast cancer and HER2-enriched subtypes. Positive FOXC1 expression was higher in ER-negative cases than ER-positive cases (39 vs. 21%) with statistical significance (P = 0.01). Similarly, positive FOXC1 was higher in PR-negative cases than PR-positive cases (37.5 vs. 20%), this was statistically significant (P = 0.009). In our series, FOXC1 expression was not associated with survival. Conclusion FOXC1 expression is associated with negative hormonal-receptor status in breast cancer. FOCX1 is not a prognostic indicator of disease-free survival in our patient series.