J Breast Cancer.  2017 Mar;20(1):54-64. 10.4048/jbc.2017.20.1.54.

Prognostic Influence of BCL2 on Molecular Subtypes of Breast Cancer

Affiliations
  • 1Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea. kiterius@snu.ac.kr
  • 2Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Korea.
  • 4College of Pharmacy, Sookmyung Women's University, Seoul, Korea.
  • 5Department of Pathology, Seoul National University Boramae Medical Center, Seoul, Korea.

Abstract

PURPOSE
We aimed to reveal the prognostic influence of B-cell CLL/lymphoma 2 (BCL2) on molecular subtypes of breast cancer.
METHODS
We analyzed 9,468 patients with primary breast cancer. We classified molecular subtypes according to the National Comprehensive Cancer Network (NCCN) and St. Gallen guidelines, mainly on the basis of the expression of hormonal receptor (HR), human epidermal growth factor receptor 2 (HER2), and Ki-67.
RESULTS
Regarding NCCN classification, BCL2 was a strong favorable prognostic factor in the HR(+)/HER2(-) subtype (p<0.001) and a marginally significant favorable prognosticator in the HR(+)/HER2(+) subtype (p=0.046). BCL2 had no prognostic impact on HR(-)/HER2(+) and HR(-)/HER2(-) subtypes. In relation to St. Gallen classification, BCL2 was a strong favorable prognosticator in luminal A and luminal B/HER2(-) subtypes (both p<0.001). BCL2 was a marginally significant prognosticator in the luminal B/HER2(+) subtype (p=0.046), and it was not a significant prognosticator in HER2 or triple negative (TN) subtypes. The prognostic effect of BCL2 was proportional to the stage of breast cancer in HR(+)/HER2(-), HR(+)/HER2(+), and HR(-)/HER2(-) subtypes, but not in HR(-)/HER2(+) subtype. BCL2 was not a prognostic factor in TN breast cancer regardless of epidermal growth factor receptor expression.
CONCLUSION
The prognostic influence of BCL2 was different across molecular subtypes of breast cancer, and it was largely dependent on HR, HER2, Ki-67, and the stage of cancer. BCL2 had a strong favorable prognostic impact only in HR(+)/HER2(-) or luminal A and luminal B/HER2(-) subtypes, particularly in advanced stages. Further investigations are needed to verify the prognostic influence of BCL2 on molecular subtypes of breast cancer and to develop clinical applications for prognostication using BCL2.

Keyword

Bcl-2; Breast neoplasms; Prognosis; Survival analysis; Triple negative breast neoplasms

MeSH Terms

B-Lymphocytes
Breast Neoplasms*
Breast*
Classification
Humans
Phenobarbital
Prognosis
Receptor, Epidermal Growth Factor
Survival Analysis
Triple Negative Breast Neoplasms
Phenobarbital
Receptor, Epidermal Growth Factor
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