Background: The role of apoptosis (programmed cell death) in the devel
opment and progression of breast cancer is unknown. Recently the bcl-2
gene has been shown to block apoptosis and thus may promote tumour de
velopment. BCL-2 is localised to the luminal cells of the normal breas
t, which are considered to be the origin of malignant breast disease.
Patients and methods: Immunocytochemistry using anti bcl-2- antibody w
as performed on 107 breast cancer specimens belonging to node-positive
patients from the Ludwig Breast Cancer Studies I-IV and the results w
ere correlated with survival, tumour grade, S-phase, oestrogen and pro
gesterone receptor status and c-erb B-2 expression. Western and Southe
rn blotting together with immunofluorescence were performed on the bre
ast cancer cell lines BT-20, BT-474, MDA-MB-361, T47-D and MCF-7. Resu
lts: In the breast cancer derived cell line MCF-7 BCL-2 is expressed t
o a level similar to that of the B-lymphoma cell line Karpas 231 with
t(14;18)(q32.3; q21.3), but no evidence of a rearrangement or gene amp
lification was identified. In a study of 107 breast cancers from the I
nternational Breast Cancer Study Group Trials I-IV we have demonstrate
d a very significant inverse correlation of BCL-2 with c-erbB-2 expres
sion (p = 0.002), and a positive correlation with oestrogen receptors
(p = 0.001) and progesterone receptors (p = 0.05). In this study there
was no correlation of expression with S-phase fraction in the tumours
or with any stage in the cell cycle as assessed in MCF-7 cells. Concl
usion: We conclude that BCL-2 might contribute to the malignant phenot
ype of breast cancer by modulation of biological behaviour of cancer c
ells.