A prospective trial of midwest breast cancer patients: A p53 gene mutationis the most important predictor of adverse outcome

Several retrospective studies have suggested p53 gene mutation as an advers e prognostic indicator in breast cancer patients, based on a selective grow th advantage of p53 mutant cancer cells and their presumed resistance to cu rrent adjuvant therapy regimens. A cohort of 90 Caucasian midwestern breast cancer patients was analyzed prospectively (60 months of follow-up) with a rigorous mutation detection methodology. The presence of a p53 gene mutati on was the single most adverse prognostic indicator for recurrence (p = 0.0 032) and death (p = 0.0001), and was associated with poor response to both adjuvant (p = 0.0001) and palliative (p = 0.006) therapy. Analysis of the p 53 gene with appropriate mutation detection methodology markedly improves t he prediction of early recurrence. treatment failure, and death in breast c ancer patients. (C) 2000 Wiley-Liss, Inc.