title: Evaluation of prognostic factors in stage IIA breast tumors and their correlation with mortality risk.
abstract: Breast tumors exhibit extensive molecular and clinical heterogeneity. One of the most utilized breast carcinoma classifications is based on its molecular aspects and subdivides breast cancer into five major groups based on the expression of certain genes. In this study, we evaluated which factors are important in determining a prognosis after 5 years of follow-up for patients with clinical stage IIA breast tumors. We took into consideration the different phenotypes (luminal A luminal B HER-2 overexpression, basal and triple-negative), various epithelial-mesenchymal (EMT) molecular markers and adhesion molecules (E-cadherin, P-cadherin, N-cadherin, vimentin, twist snail and slug) and NOS-2, in addition to clinical and demographic data, tumor characteristics and treatment types.
  
  
  METHODS
  The study population consisted of 82 patients with breast cancer. We analyzed eight molecular markers by immunohistochemistry on tissue microarrays containing breast tumor specimens from patients with ten years of follow-up, and we classified each tumor according to its estrogen receptor, progesterone receptor and HER-2 expression. We then placed the tumor into one of the above categories.
  
  
  RESULTS
  The presence of several clinical and demographic factors, various histopathologies, treatment forms and several immunohistochemical markers were not associated with a worse prognosis for group IIA patients. The factors that were associated with a mortality risk were the triple-negative (odds ratio (OR) = 11.8, 95% confident interval (CI) = 2.0-70.3, P = 0.007) and basal (OR =18.4, 95% CI = 1.8-184.7, P= 0.013) phenotypic patterns.
  
  
  CONCLUSIONS
  The EMT markers and NOS-2 were not mortality risk factors. Basal and triple-negative phenotypic patterns were related to a higher mortality risk in patients with stage IIA tumors.
authors.affiliation: Department of Breast Surgery, Hospital do Câncer- A C Camargo, São Paulo, SP, Brazil. solcarvalho@uol.com.br
authors.forename: Solange Torchia
authors.initials: ST
authors.lastname: Carvalho
authors.forename: Monica Maria
authors.initials: MM
authors.lastname: Stiepcich
authors.forename: José Humberto
authors.initials: JH
authors.lastname: Fregnani
authors.forename: Sueli
authors.initials: S
authors.lastname: Nonogaki
authors.forename: Rafael
authors.initials: R
authors.lastname: Rocha
authors.forename: Fernando Augusto
authors.initials: FA
authors.lastname: Soares
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D002280:Basal Cell Carcinoma / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D052247:Nitric Oxide Synthase Type II / Q000032:analysis; D010641:Phenotype; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D052247:Nitric Oxide Synthase Type II; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone