title: Impact of GATA-3 and FOXA1 expression in patients with hormone receptor-positive/HER2-negative breast cancer.
abstract: BACKGROUND
  Determining the indications for adjuvant chemotherapy (CT) in patients with hormone receptor (HR)-positive/HER2-negative breast cancer are difficult. The transcription factors GATA-binding protein 3 (GATA-3) and Forkhead-box protein A1 (FOXA1) are crucial for the hormone responsive phenotype of breast cancer. This study evaluated whether the expression of GATA-3 and FOXA1 is a prognostic and predictive marker of outcomes in patients with HR-positive/HER2-negative breast cancer.
  
  
  METHODS
  The expression of GATA-3 and FOXA1 was analyzed immunohistochemically in 214 patients with invasive breast cancer to evaluate the association with the clinicopathological features and the prognosis.
  
  
  RESULTS
  GATA-3 expression was positively correlated with FOXA1 expression (P < 0.0001). Both GATA-3 and FOXA1 were positively correlated with ER (P < 0.0001 each) and PR expression (P = 0.0001 and P = 0.0009, respectively), and inversely correlated with nuclear grade (P = 0.0002 and P = 0.0018, respectively) and Ki67 index (P = 0.0052 and P = 0.0049, respectively). Expression of GATA-3 and FOXA1 was associated with better prognosis. FOXA1 was an independent favorable prognostic marker in HR-positive/HER2-negative breast cancer. Disease-free survival rates were similar in patients with HR-positive/HER2-negative breast cancer and high FOXA1 expression given adjuvant hormone therapy (HT) alone and those given CT plus HT.
  
  
  CONCLUSIONS
  GATA-3 and FOXA1 are associated with a less aggressive phenotype and a better prognosis in patients with HR-positive/HER2-negative breast cancer. FOXA1 may be useful in identifying those patients who may not require adjuvant CT.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hisamatsu
authors.forename: Eriko
authors.initials: E
authors.lastname: Tokunaga
authors.forename: Nami
authors.initials: N
authors.lastname: Yamashita
authors.forename: Sayuri
authors.initials: S
authors.lastname: Akiyoshi
authors.forename: Satoko
authors.initials: S
authors.lastname: Okada
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Nakashima
authors.forename: Kenji
authors.initials: K
authors.lastname: Taketani
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Oda
authors.forename: Masaru
authors.initials: M
authors.lastname: Morita
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D050990:GATA3 Transcription Factor / Q000378:metabolism*; D051541:Hepatocyte Nuclear Factor 3-alpha / Q000378:metabolism*; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D050990:GATA3 Transcription Factor; D051541:Hepatocyte Nuclear Factor 3-alpha; D019394:Ki-67 Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C496499:FOXA1 protein, human; C508053:ERBB2 protein, human