Cyclin D1 expression predicts poor response to neoadjuvant chemotherapy and survival in late stage breast cancer patients

ABSTRACT

We evaluated the prognostic value of cyclin D1, epidermal growth factor receptor [EGFR] and MIB expression in Late Stage breast carcinoma, and their relationship with clinicopathologic response to neoadjuvant chemotherapy. We identified 45 patients who presented with locally advanced breast cancer [T2-T4], diagnosed with core needle biopsies, and treated with neoadjuvant chemotherapy, followed by conservative breast surgery [27/45,60%] with axillary lymph node dissection or modified radical mastectomy [18/45, 40%]. Complete pathologic response was defined as absence of invasive carcinoma at resection, while incomplete pathologic response was defined as having any invasive carcinoma. Cases were immunostained for cyclin D1, EGFR and MIB-1. Cyclin D1 ovcrexpression was found in 47% [21/45] of the cases and correlated with positive estrogen receptor [ER] expression [p < 0.01]. EGFR was positive in 16/45 [36%] of the cases which was expressed in the cytoplasm of the cancer cells, with occasional cell membrane staining. MIB-1 [>20%] was expressed in 15/45 [33%] of the cases. There were significant association between cyclin D1 overexpression and poor pathologic response [r=0.43, P=0.006], Cyclin D1 has significant adverse effect on overall survival and relapse-free survival [Log rank, p=0.05]. Overall, cyclin D1 overexpression was not associated with other clinicopathological features. EGFR was significantly expressed in ER and PR negative tumors [r=0.68 and 0.36, respectively]. Both EGFR and MIB-1 showed no significant correlation with pathologic response. Our findings indicate that cyclin D1 overexpression correlates with poor response to neoadjuvant chemotherapy and a worse survival in locally advanced breast cancer patients [T2-T4]