Investigation of Telomerase Activity in Inflammatory and Non Inflammatory Breast Cancer

Abstract

Background: Inflammatory breast cancer (IBC) is an aggressive type of breast cancer disease that has a high incidence in Egypt than western countries. It is characterized by rapid progression, involvement of dermal lymphatic emboli and extensive lymph node involvement. Basic and translational studies are needed to define IBC disease biology and identify specific biomarkers have been limited by the paucity of patient samples. Hence, the current study aimed to introduce the telomerase activity level as a novel diagnostic marker for breast cancer and specifically for IBC to be differentiated from non-IBC. Methods: Breast cancer patients were enrolled from Ain Shams University hospitals in Cairo, divided into two groups: IBC (n=26) and non-IBC (n=27). Tissue samples were collected during modified radical mastectomy. TRAP (Telomerase repeat amplification protocol) assay was used to assess the telomerase activity in inflammatory and non inflammatory breast cancer tissue samples. Immunohistochemistry was used to investigate the expression of hTERT subunit of telomerase in paraffin embedded tissue samples of both types of patients. Results: IBC showed Telomerase activity ranged from 12.2 to 367.1 units with a mean value of 78 and a median value of 43, while telomerase activity in non-IBC ranged from 6.1 to 109.34 units with a mean value of 41.1 and a median value of 24. On the other hand, normal tissues showed telomerase activity below 5 (P<0.001). Using immunohistochemistry, the hTERT expression was higher in IBC than non-IBC and no expression at all in normal tissues. Moreover, a positive mild correlation was found between the telomerase activity and the number of metastatic lymph nodes in both IBC (r=0.53) and non-IBC (r=0.54). Conclusions: Telomerase could be a promising marker at the diagnostic and therapeutic levels in breast cancer and specifically in IBC.