THE POSSIBLE PROGNOSTIC-SIGNIFICANCE OF P53 IMMUNOSTAINING STATUS OF THE PRIMARY TUMOR IN PATIENTS DEVELOPING LOCAL RECURRENCE AFTER BREAST-CONSERVING SURGERY

Prognostic factors for distant metastases in patients with local recur rence after breast-conserving treatment (BCT) were studied. Fifty-six patients who developed local recurrence after BCT were recruited from 18 key hospitals/institutes in Japan. AU 10 patients whose primary tum ors were DCIS fared well without evidence of distant failure for a med ian follow-up period of 57 months (range 41-72) after the local recurr ence. Inflammatory local recurrence was observed in 5 patients whose p rognosis was grave: 3 with concomitant distant metastases and 1 develo ping them 7 months later. In the remaining 41 patients with noninflamm atory local recurrence, various clinicopathological factors including age, disease-free interval, histology of the primary and recurrent tum ors, axillary lymph node status, estrogen and progesterone receptor, i mmunohistochemical staining of erbB2 and p53 protein were evaluated as prognostic factors. Only the p53 immunostaining status of the primary tumor was found to be a significant prognostic indicator for distant metastases; distant disease-free survival at 5 years after the local r ecurrence was 92% for patients with p53-negative cancers and 51% for t hose with p53-positive cancers (p < 0.05).