Prognostic value of p53 molecular status in high-risk primary breast cancer

Abstract

BackgroundMutations in the p53 gene are the most common genetic alterations in human primary breast carcinoma and these mutations are often associated with worse prognosis and chemo/radioresistance. Patients and methodsThe analysis of the p53 gene was performed by fluorescence-assisted mismatch analysis in 13 consecutive high-risk primary breast cancer (HR-BC) patients with 10 or more involved axillary nodes to evaluate its prognostic value. ResultsThree p53 mutations (23%) and four allelic variants were detected. After a median follow-up of 52 months the HR-BC disease-free survival (DFS) was 51% and overall survival 79%. All patients harboring a p53 mutation (p53mut) relapsed within 10 months of the median DFS while 67% of those showing a wild-type p53 status (p53wt) survive disease-free at a median follow-up of 43 months. One p53mut patient is still alive while all the p53wt patients survive at 56 months median follow-up. Two out of the four p53wt relapsing breast cancer patients showed the Arg72Pro allelic variant; one of these died at 75 months. Conclusionsp53 mutations may help identify a subset of very high risk breast cancer patients (vHR-BC) with worse prognosis.