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Clinicopathological and epidemiological significance of breast cancer subtype reclassification based on p53 immunohistochemical expression

dc.contributor.authorAbubakar, Mustapha
dc.contributor.authorGuo, Changyuan
dc.contributor.authorKoka, Hela
dc.contributor.authorSung, Hyuna
dc.contributor.authorShao, Nan
dc.contributor.authorGuida, Jennifer
dc.contributor.authorDeng, Joseph
dc.contributor.authorLi, Mengjie
dc.contributor.authorHu, Nan
dc.contributor.authorZhou, Bin
dc.contributor.authorLu, Ning
dc.contributor.authorYang, Xiaohong R.
dc.identifier.citationAbubakar, M., Guo, C., Koka, H. et al. Clinicopathological and epidemiological significance of breast cancer subtype reclassification based on p53 immunohistochemical expression. npj Breast Cancer 5, 20 (2019).
dc.identifier.othereISSN 2374-4677
dc.description.abstractTP53 mutations are common in breast cancer and are typically associated with more aggressive tumor characteristics, but little is known about the clinicopathological and epidemiological relevance of p53 protein expression, a TP53 mutation surrogate, in breast cancer subtypes. In this study of 7226 Chinese women with invasive breast cancer, we defined breast cancer subtypes using immunohistochemical (IHC) measures of hormone receptors and HER2 in conjunction with histologic grade. p53 expression status was then used to further stratify subtypes into p53-positive and p53-negative. Odds ratios (ORs) and 95% confidence intervals (Cis) in case-only logistic regression analyses were used to examine heterogeneity across different subtypes. The frequency of p53 protein expression varied by breast cancer subtype, being lowest in the luminal A-like and highest in the triple-negative and HER2-enriched subtypes (P-value <0.01). In luminal A-like and B-like/HER2-negative subtypes, p53 positivity was associated with early-onset tumors, high grade, high proliferative index, and basal marker (CK5/6 and EGFR) expression. Further, compared with luminal A-like/p53-negative patients, A-like/p53-positive patients were more likely to be parous [adjusted OR (parous vs. nulliparous) = 2.67 (1.60, 4.51); P-value < 0.01] and to have breastfed [adjusted OR (ever vs. never) = 1.38 (1.03, 1.85); P-value = 0.03]. p53 positivity was not associated with examined clinical and risk factors in other tumor subtypes. Overall, these findings suggest that p53 expression, which is readily available in many settings, can be used to identify phenotypes of luminal A-like breast cancer with distinct clinical and epidemiological implications.en_US
dc.description.sponsorshipThis research was supported by the Intramural Research Program of the National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics, USAen_US
dc.publisherNPJ Breast Canceren_US
dc.rightsOpen Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit
dc.titleClinicopathological and epidemiological significance of breast cancer subtype reclassification based on p53 immunohistochemical expressionen_US

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