title: Impact of cyclooxygenase-2 over-expression on the prognosis of breast cancer patients.
abstract: OBJECTIVE
  The aim of this present study was to assess the impact of COX-2 over-expression on breast cancer survival.
  
  
  METHODS
  Non-metastatic invasive breast cancer patients who received adequate loco-regional and systemic treatments were evaluated. Patients' demographic, clinical, pathologic, and treatment-related and survival data were retrieved from their hospital files. COX-2, estrogen/progesterone receptor (ER/PR), HER-2/neu expression and Ki67 index of the tumors were determined immunohistochemically. As the primary objective, COX-2 positive and negative patients were compared in terms of overall (OS), disease-free (DFS) and breast cancer-specific survival (BCSS). Secondary objectives were to assess the independent prognostic factors for survival. In addition, the correlation of COX-2 expression with conventional prognostic and predictive factors of breast cancer was assessed.
  
  
  RESULTS
  Two hundred and seventeen patients who underwent adequate breast cancer treatment between November 2004 and December 2013 were included in the study. The median follow-up was 37 months (range: 5-107). Eighty-one (37%) patients were COX-2 positive. OS, DFS, and BCSS were similar in COX-2 positive and negative patients. Ki67 index and age were significantly correlated with COX-2 expression (r=-0.116; p=0.02; r=0.159; p=0.02). PR expression was found to be the only independent factor for predicting OS, tumor size and molecular subtype classification were found to be the only independent factors for predicting DFS, and PR expression was found to be the only independent factor for predicting BCSS.
  
  
  CONCLUSIONS
  Among the independent predictive and prognostic factors of breast cancer, COX-2 over-expression was only correlated with Ki67 index and age.
authors.affiliation: Department of General Surgery, Marmara University School of Medicine, İstanbul, Turkey.
authors.forename: Sertaç Ata
authors.initials: SA
authors.lastname: Güler
authors.affiliation: Department of General Surgery, Marmara University School of Medicine, İstanbul, Turkey.
authors.forename: Mustafa Ümit
authors.initials: MÜ
authors.lastname: Uğurlu
authors.affiliation: Department of Pathology, Marmara University School of Medicine, İstanbul, Turkey.
authors.forename: Handan
authors.initials: H
authors.lastname: Kaya
authors.affiliation: Department of General Surgery, Marmara University School of Medicine, İstanbul, Turkey.
authors.forename: Semiha
authors.initials: S
authors.lastname: Şen
authors.affiliation: Department of General Surgery, Marmara University School of Medicine, İstanbul, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Nazlı
authors.affiliation: Department of General Surgery, Marmara University School of Medicine, İstanbul, Turkey.
authors.forename: Bahadır M
authors.initials: BM
authors.lastname: Güllüoğlu
keywords: Breast cancer; cyclooxygenase-2 enzyme; predictive factors; prognostic factors; survival