Matrix metalloproteinase-2 (MMP-2) is associated with the risk for a relapse in postmenopausal patients with node-positive breast carcinoma treated with antiestrogen adjuvant therapy

Node-positive breast carcinoma is an aggressive disease. Postmenopausal pat ients benefit from antiestrogen adjuvant therapy. Predictive markers could, however, be useful in selecting these patients for different modalities of adjuvant therapy. Recently, we showed that MMP-2 (72 kD type IV collagenas e/gelatinase A) is correlated with unfavorable prognosis in premenopausal b reast carcinoma patients. Expression of the immunoreactive protein for MMP- 2 was evaluated prospectively in this study in paraffin tissue sections fro m primary tumors of 100 postmenopausal, node-positive breast carcinoma pati ents treated with an adjuvant antiestrogen therapy. A specific MMP-2 monocl onal antibody in an avidin-biotin immunohistochemical staining was used. Si xty nine percent of the samples were MMP-2 positive. Eighty three percent o f the MMP-2 negative patients lived for 5 years without a recurrence, while only 67% of the patients with an MMP-2 positive primary tumor were recurre nce-free at that time (p < 0.0; log rank analysis). MMP-2 positivity showed a significant correlation with shortened survival in patients with a small primary tumor (T1-2) and a low axillary tumor burden. One hundred percent of these patients with an MMP-2 negative breast carcinoma survived for 5 ye ars, compared to 73% of the MMP-2 positive cases alive at that time (p = 0. 02). In conclusion, we show here that MMP-2 is a prognostic indicator in po stmenopausal patients with node-positive breast carcinoma with a low tumor burden, and that it predicts a risk for failure in antiestrogen adjuvant th erapy. It might have predictive value in selecting the most efficient adjuv ant therapy in this set of patients.