Fibroblast growth factor 2 expression on lymph node metastasis in early-stage breast cancer

Abstract

Introduction: Axillary lymph node involvement is an important aspect of breast cancer diagnosis in determining treatment and predicting distant metastasis. Lymph node metastasis is associated with higher recurrence and survival rates. Lymph node status is a significant prognostic factor and is widely used. Several factors affect lymph node metastasis, including tumor size, grade, and invasive ductal histological type. FGF2, a lymphangiogenesis factor, influences the occurrence of lymph node metastasis. The present study aimed to determine the association between FGF2 expression and axillary lymph node metastasis in early-stage breast cancer and evaluate the association between FGF2 expression and clinicopathologic factors. Methods: A cross-sectional design was used to evaluate the expression of FGF2 in 47 early-stage breast cancer patients who underwent either a mastectomy or breast-conserving surgery procedure at Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, from January 2014 to December 2018. FGF2 expression was examined by immunohistochemistry. Results: FGF2 expression was significantly correlated with axillary lymph node metastasis incidence [p = 0.044, odds ratio 4.22 (95% CI 0.983-18.1)]. Higher FGF2 expression was significantly correlated with the grade, subtype, estrogen receptor (ER) status, and progesterone receptor (PR) status of the tumor (p = 0.017, p = 0.031, p = 0.002, p = 0.013, respectively). Conclusions: Increased FGF2 expression and tumor size significantly correlated with axillary lymph node metastasis. The tumor's grade, intrinsic subtype, ER and PR status were significantly correlated with increased FGF2 expression. Our study indicated that FGF2 expression might aid in determining the presence of axillary lymph node metastasis.