Background: There are indications to support the knowledge about the prognosis of breast cancer. One of these markers is regarded as a prognostic factor and related to the proliferation rate. Topoisomerase IIα (TOP2A), encoded by the TOP2A gene, is a molecular target for anthracycline therapy. Aims: The aim of this article is to establish any association of the status of topoisomerase IIa immunohistochemistry with different prognostic clinicopathological and molecular parameters in breast cancer. Settings and Design: A cross-sectional retrospective study was carried out in the Department of Pathology and Forensic Medicine, Faculty of Medicine, Babylon University, during the period from January 2020 through December 2020. Materials and Methods: Fifty cases with invasive breast carcinoma have been obtained from surgical modified radical mastectomy specimens from the Laboratory of Histopathology in Al-Kafeel Specialized Hospital, Karbala for the last 3 years (2017–2019). Different clinicopathological variables were estimated. The expression of TOP2A was stained by using the PathnSitu PolyExcel Detection System of Immunostaining. Statistical Analysis Used: Immunostaining with TOP2A expression used a cut-off value of 10%. The results were considered statistically significant if the P-value was ≤ 0.05. Results: Fifty cases of TOP2A overexpression were classified as follows: 28 cases (56%) had 3+ expression, 4 cases (8%) with 2+ expression, and 4 cases (8%) with 1+ expression, whereas 14 cases had no expression of TOP2A (28%). TOP2A overexpression was shown to be associated with a higher grade (P = 0.023) and molecular subtypes (P = 0.057), but not with other clinicopathological parameters (age of patients, type of histology, number of lymph nodes involved, tumor size). Conclusion: According to these results, TOP2A plays a major role in the aggressive nature of tumors. This may support the suggestion to be used as a prognosis marker.
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