p53 mutation, deprivation and poor prognosis in primary breast cancer.
BACKGROUND
The deprivation gap for breast cancer survival remains unexplained by stage at presentation, treatment, or co-morbidities. We hypothesised that p53 mutation might contribute to the impaired outcome observed in patients from deprived communities.


METHODS
p53 mutation status was determined using the Roche Amplichip research test in 246 women with primary breast cancer attending a single cancer centre and related to deprivation, pathology, overall, and disease-free survival.


RESULTS
p53 mutation, identified in 64/246 (26%) of cancers, was most common in 10 out of 17 (58.8%) of the lowest (10th) deprivation decile. Those patients with p53 mutation in the 10th decile had a significantly worse disease-free survival of only 20% at 5 years (Kaplan-Meier logrank chi(2)=6.050, P=0.014) and worse overall survival of 24% at 5 years (Kaplan-Meier logrank chi(2)=6.791, P=0.009) than women of deciles 1-9 with p53 mutation (c.f. 56% and 72%, respectively) or patients in the 10th decile with wild-type p53 (no disease relapse or deaths).


CONCLUSIONS
p53 mutation in breast cancer is associated with socio-economic deprivation and may provide a molecular basis, with therapeutic implications, for the poorer outcome in women from deprived communities.
Baker
L
L
Department of Surgery and Molecular Oncology, Dundee University, Ninewells Hospital and Medical School, UK. l.baker@dundee.ac.uk
Quinlan
P R
PR
Patten
N
N
Ashfield
A
A
Birse-Stewart-Bell
L-J
LJ
McCowan
C
C
Bourdon
J-C
JC
Purdie
C A
CA
Jordan
L B
LB
Dewar
J A
JA
Wu
L
L
Thompson
A M
AM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000401:mortality / Q000523:psychology; D005260:Female; D005787:Gene Frequency; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D011610:Psychosocial Deprivation; D012923:Social Class; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000235:genetics*
D016159:Tumor Suppressor Protein p53