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Association of p53 Overexpression with Hormone Receptor Status and Triple Negative Breast Carcinoma.

OBJECTIVE: To determine association of p53 overexpression with hormone receptor status in breast carcinoma.

STUDY DESIGN: Descriptive cross-sectional study.

PLACE AND DURATION OF STUDY: Department of Pathology in collaboration with Department of Oncology, King Edward Medical University, Lahore, from January 2017 to January 2018.

METHODOLOGY: All adult female patients coming to Department of Oncology with reports of breast cancer biopsy and receptor status were included. Their age, type of surgery, grade of cancer, stage of cancer, and hormone receptor status were noted from records. P53 immunomarker was applied on tumor containing tissue blocks. Pearson Chi-square test was run for strength of association between the variables using SPSS V. 22.

RESULTS: Mean age of 91 patients at diagnosis was 48 years ±12.49. Fifty-five (60.4%) patients had ER positive tumors, 36 (39.6%) were ER negative, 53 (58.2%) had PR positive status, and 38 (41.8%) were negative. Same number was seen in HER2 neu staining. Out of 91 cases, 31 (34.1%) were p53 positive and 60 (65.9%) were negative. Out of 55 (60.4%) ER positive cases, 11 (12.1%) were positive for p53 and 44 (48.4%) were p53 negative (p<0.001). PR positive cases (53/58.2%) showed p53 positivity in 7 (7.7%) and negativity in 46 (50.5%) cases (p< 0.001). HER2 positive cases were positive for p53 stain in 8 (8.8%) and negative in 45 (49.5%) cases (p<0.001). Fifteen (16.48%) biopsies were negative for all three hormone receptors. P53 was positive in all of these hormone receptor negative tumors (15/15, 100%), although 9 (60%) showed strong positivity and 6 (40%) exhibited weak staining intensity of p53.

CONCLUSION: P53 overexpression is less frequent in hormone receptor positive breast cancers. However, hormone receptor negative (triple negative) tumors overwhelmingly overexpress p53 protein in tumor cells. P53, detected either immunohistochemically or serologically, can serve to predict poor prognosis and survival in breast cancer patients, unless newer anti-p53 treatments are introduced in Pakistan.

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