MMP-2 positivity and age less than 40 years increases the risk for recurrence in premenopausal patients with node-positive breast carcinoma

Node-positive breast carcinoma is associated with a poor prognosis. Some pa tients benefit from adjuvant chemotherapy but new treatment modalities shou ld still be developed in order to further increase the cure rate in this pa tient group. Prognostic factors are needed to define patients for such stud ies. Here, the prognostic value of matrix metalloproteinase-2 (MMP-2) and a ge was evaluated in 108 premenopausal, node-positive breast carcinoma patie nts treated with an adjuvant chemotherapy. Expression of MMP-2 protein was studied in paraffin-embedded tissue sections from primary tumors by using s pecific MMP-2 monoclonal antibody in an immunohistochemical staining. Age l ess than 40 years predicted 5-year recurrence free survival (RFS) as unfavo rable, being 74% in patients 41-49 years of age and 54% in those under age 40 (p = 0.02). The 5-year RFS rate was 85% in patients with an MMP-2 negati ve primary tumor while it was 65% in the MMP-2 positive patient group. This difference was not, however, statistically significant (p = 0.07). Correla tion between hematogenous metastasis and MMP-2 positivity in breast carcino ma was demonstrated for the first time (p = 0.03). A risk group for a relap se was identified using MMP-2 immunohistochemistry and age. The RFS rate in patients less than 40 years with an MMP-2 positive primary tumor was only 50% while it was 74% in other premenopausal patients (p = 0.007). Young age and MMP-2 positivity may, thus, associate with early relapse in node-posit ive breast carcinoma.