Ann Surg Treat Res.  2020 Jun;98(6):291-298. 10.4174/astr.2020.98.6.291.

Differences in prognosis by p53 expression after neoadjuvant chemotherapy in triple-negative breast cancer

• Bae SY
• Lee JH
• Bae JW
• Jung SP

• KMID: 2502114
• DOI: http://doi.org/10.4174/astr.2020.98.6.291

Abstract

Purpose
Our previous studies suggested that p53-positive triple-negative breast cancer (TNBC) should be more sensitive to chemotherapy than p53-negative TNBC. The aim of this study was to determine whether p53 expression in TNBC could predict response to neoadjuvant chemotherapy and the resulting prognosis.
Methods
From January 2009 to December 2017, TNBC patients who underwent neoadjuvant chemotherapy were reviewed, including a total of 31 TNBC patients who had clinical lymph node metastasis. The status of p53 expression in patients before and after chemotherapy was evaluated.
Results
Two patients (22.2%, 2 of 9) achieved pCR in p53(+) TNBC and 4 patients (50%, 5 of 10) achieved pCR in p53(-) TNBC. There was no correlation between pCR rate and p53 expression (P = 0.350). Based on prechemotherapy p53 expression, there was no significant difference in disease-free survival (DFS) between p53(+) TNBC and p53(-) TNBC (P = 0.335). However, after chemotherapy, p53(+) TNBC had shown higher DFS than p53(-) TBNC (P = 0.099). Based on prechemotherapy p53 expression, p53(+) TNBC had better overall survival (OS) than p53(-) TNBC, but the difference was not statistically significant (P = 0.082). After chemotherapy, p53(+) TNBC showed significantly better OS than p53(-) TNBC (P = 0.018).
Conclusion
Immunohistochemically detected p53 expression in TNBC could not predict the response to neoadjuvant chemotherapy. However, p53(+) TNBC had a better OS than p53(-) TNBC in patients who underwent neoadjuvant chemotherapy.

Keyword

Immunohistochemistry; Neoadjuvant therapy; Prognosis; Triple negative breast neoplasms; Tumor suppressor potein p53

Figure

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  Fig. 1 Survival plotted by chemotherapy response: (A) disease-free survival and (B) overall survival. pCR, pathologic complete response.

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  Fig. 2 Survival plotted by p53 expression: (A) disease-free survival (DFS) by prechemotherapy p53 status, (B) disease-free survival by postchemotherapy p53 status, (C) overall survival by prehemotherapy p53 status, and (D) overall survival by posthemotherapy p53 status.

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  Fig. 3 Survival plotted by N stage; (A) disease-free survival by clinical N stage, (B) overall survival by clinical N stage, (C) disease-free survival by pathologic N stage (yp N stage), and (D) overall survival by pathologic N stage.

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