Abstract
BackgroundTopoisomerase II alpha (Top 2 A) protein has been shown to be a proliferation marker associated with tumour grade. The current study evaluated the prognostic impact of Top 2 A protein on luminal breast cancer and its utility as an independent prognostic marker. Immunohistochemical expression of Top 2 A in breast cancer and its correlation with the tumour type, size, lymph node metastases, grade and ER/PR positivity.MethodologyEthics committee approval was taken and 65 cases of Invasive breast carcinoma presenting to the Department of Pathology at a tertiary care centre in South India were studied. Patient details including age, tumour type, tumour size, tumour grading, estrogen receptor (ER)/progesterone receptor (PR)/human epidermal growth factor receptor 2 (HER2/neu) status and pathologic stage was studied. Immunohistochemistry (IHC) work-up for Top 2 A expression was done and evaluated.ResultsOf the 65 histological sections of breast cancers, 29/65 showed nuclear positivity for Top 2 A. Node positive tumours 17/65 stained positive for Top 2 A. Stage I tumours 2/65, stage II tumours 12/65 and stage III 14/65 stained positive for Top 2 A. Among the HER2/neu-positive tumours, 22/65 stained for Top 2 A and among ER/PR-positive 9/65 cases were positive for Top 2 A. Triple-negative tumours 5/65 stained for Top 2 A.ConclusionHigher Top 2 A expression was seen in higher stage tumours. HER2/neu-positive tumours significantly showed a correlation with Top 2 A positivity. Therefore, Top 2 A expression can be considered an individual prognostic factor in breast carcinoma.
Highlights
Worldwide, breast cancer is the most frequently diagnosed life-threatening cancer in women
The current study evaluated the prognostic impact of Top 2 A protein on luminal breast cancer and its utility as an independent prognostic marker
The current study focuses on the association of Top 2 A expression with tumour grade, stage, molecular type and its use as an independent prognostic marker
Summary
Breast cancer is the most frequently diagnosed life-threatening cancer in women. In lessdeveloped countries, it is the leading cause of cancer death in women. For many years the hormone receptors expression has been the prognostic and therapeutic marker in invasive breast cancer. New markers like topoisomerase II alpha have been proposed as a prognostic and targeted therapy marker. Studies in this context are only limited and have shown varying results as predictors for disease outcome with this marker. Topoisomerase II alpha (Top 2 A) protein has been shown to be a proliferation marker associated with tumour grade. Immunohistochemical expression of Top 2 A in breast cancer and its correlation with the tumour type, size, lymph node metastases, grade and ER/PR positivity
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