CHING-HUNG LINYEN-SHEN LUCHIUN-SHENG HUANGKUAN-TING KUOWang C.-C.You S.-L.PO-HAN LINDWANG-YING CHANGWEN-HUNG KUOKING-JEN CHANGANN-LII CHENG2020-03-072020-03-0720110021-9746https://www.scopus.com/inward/record.uri?eid=2-s2.0-80051897884&doi=10.1136%2fjclinpath-2011-200064&partnerID=40&md5=aeca3776d8f81f1a3319f1306968f538https://scholars.lib.ntu.edu.tw/handle/123456789/473580Background: Women aged ?35 years with breast cancer have a poor prognosis, but their prognostic factors have not been clearly defined. Aims: To evaluate whether the molecular markers used in age-unspecified breast cancer could also be applied to women ?35 years. Methods: Archival tumours from patients aged ?35 years with stage I-III breast cancer were collected. Oestrogen receptor (ER), progesterone receptor (PR), HER2, Ki67 and P53 protein expression profiles in paraffin-embedded tissue sections were determined by immunohistochemistry. Tumours with an HER2 score of 2+ were further evaluated by fluorescence in situ hybridisation. Mutational analysis of exons 4-9 of the TP53 gene and exons 9 and 20 of the PIK3CA gene was carried out using direct sequencing analysis. Results: 116 patients with a median follow-up duration of 62.7 months were included. In addition to tumour size and axillary lymph node status, univariate analysis showed that high Ki67 expression, ER-negative, HER2 overexpression, and TP53 mutations were associated with shorter overall survival. Multivariate analysis showed that high Ki67 expression (HR=3.93, p=0.005), HER2 overexpression (HR=3.21, p=0.013) and TP53 mutations (HR=4.44, p=0.005) were associated with shorter overall survival. PR expression and PIK3CA mutations were not associated with survival. Conclusions: For women ?35 years, TP53 mutations, Ki67 and HER2 expressions are strong prognostic factors. The limited prognostic value of hormone receptors suggests that the prognostic markers used in age-unspecified breast cancer may not be completely fit for this population.[SDGs]SDG3anthracycline; antineoplastic agent; aromatase inhibitor; cisplatin; cyclophosphamide; epidermal growth factor receptor 2; estrogen receptor; fluorouracil; Ki 67 antigen; methotrexate; molecular marker; paraffin; phosphatidylinositol 3 kinase; phosphatidylinositol 3 kinase CA; progesterone receptor; protein p53; tamoxifen; taxane derivative; trastuzumab; unclassified drug; adjuvant therapy; adult; article; axillary lymph node; breast cancer; cancer adjuvant therapy; cancer hormone therapy; cancer patient; controlled study; diagnostic test accuracy study; diagnostic value; disease free survival; disease severity; embedding; exon; female; fluorescence in situ hybridization; follow up; gene expression; gene expression profiling; gene mutation; gene overexpression; groups by age; hazard ratio; histopathology; human; human tissue; immunohistochemistry; intraductal carcinoma; lymph node metastasis; major clinical study; missense mutation; mutational analysis; overall survival; priority journal; prognosis; risk factor; sequence analysis; tissue section; tumor volume; wild type; Adult; Age Factors; Breast Neoplasms; Disease-Free Survival; DNA Mutational Analysis; DNA, Neoplasm; Female; Genes, p53; Genetic Markers; Humans; In Situ Hybridization, Fluorescence; Ki-67 Antigen; Neoplasm Staging; Phosphatidylinositol 3-Kinases; Prognosis; Receptor, erbB-2; Survival Rate; Taiwan; Tumor Markers, Biologicaljournal article10.1136/jclinpath-2011-200064216426582-s2.0-80051897884