Prognostic role of p27(Kip1) and apoptosis in human breast cancer

Human breast carcinoma is biologically heterogeneous, and its clinical cour se may vary from an indolent slowly progressive one to a course associated with rapid progression and metastatic spread. It is important to establish prognostic factors which will define subgroups of patients with low vs high risk of recurrence so as to better define the need for additional therapy. Additional characterization of the molecular make-up of breast cancer phen otypes should provide important insights into the biology of breast cancer. In the present study, we investigated apoptosis, expression of p27(Kip1) a nd p53 retrospectively in 181 human breast cancer specimens. In addition, t heir relevance to the biological behaviour of breast cancer was examined. O ur studies found a significant association among high histological grade, h igh p53, low apoptosis and low p27. Our results also demonstrated that, in human breast cancer, low levels of p27 and apoptotic index (AI) strongly co rrelated with the presence of lymph node metastasis and decreased patient s urvival. In node-negative patients, however, p27 also had prognostic value for relapse-free and overall survival in multivariate analysis. Furthermore p27 and At had predictive Value for the benefits of chemotherapy. These la tter observations should prompt prospective randomized studies designed to investigate the predictive role of p27 and Al in determining who should rec eive chemotherapy in node-negative patients.