Fatty acid synthase (FAS) is the key enzyme required for the conversion of
dietary carbohydrates to fatty acids. Recent studies have demonstrated that
high levels of FAS expression occur in a variety of cancers, including bre
ast cancer. We evaluated 243 primary breast cancer patients in the period b
etween 1989 and 1996. Immunohistochemical staining for FAS was performed on
formaline-fixed, paraffin-embedded sections. FAS staining intensity was gr
aded as low or high. The expression of FAS was high in 145 (60%) and low in
98 cases (40%). A weak correlation between FAS expression and nodal status
was noted in premenopausal patients (p=0.01). FAS was associated with estr
ogen receptor (p=0.0022) and progesterone receptor (p=0.0085) status. We fo
und that a low expression of FAS was significantly related to a shorter dis
ease-free survival (DFS) rate in estrogen receptor positive patients (p=0.0
24) and a similar trend was recognized in progesterone receptor positive pa
tients (p=0.083). The low FAS group showed better DFS and OS in all but ER-
/PgR(-) cases (p=0.011, 0.076). This study showed close correlations betwee
n immunohistochemical FAS expression and steroid hormone receptors in preme
nopausal patients. The use of FAS expression may increase the diagnostic ut
ility of ER and PgR in premenopausal patients. FAS may be able to predict t
he responsiveness of tumors to endocrine therapy.