Telomerase activity and prognosis in primary breast cancers

Purpose: Recent studies associate telomerase activity with prognostic facto rs and survival. We compared quantitative telomerase activity in primary tu mors with traditional prognostic factors and outcome in a group of invasive but nonmetastatic breast cancers. Patients and Methods: Telomerase activity was measured in 203 invasive brea st cancers by the quantitative telomeric repeat amplification protocol meth od. Telomerase expression was compared with 28S rRNA level, tumor content, and clinical variables, including outcome. For clinical correlations, telom erase activity was standardized by two methods: (1) a correction for cellul arity using 285 rRNA levels, and (2) a correction for the histologically de termined invasive proportion of the specimen. Results: Telomerase activity was found in 82% of breast cancers with measur able 28S rRNA levels. Telomerase activity was associated with the prolifera tive index (P < .01) of the tumor but not with any other prognostic variabl e. Neither uncorrected nor corrected telomerase activity was associated wit h relapse-free or overall survival in this study. Conclusion: Telomerase activity level was associated with the proliferative index of invasive breast cancers, but its measurement in samples from this group of nonmetastatic breast cancer patients did not predict survival. (C ) 1999 by American Society of Clinical Oncology.