[108] Survivin Expression in Estrogen Receptor-Positive and Triple Negative Invasive Breast Carcinoma: Correlation with Clinicopathologic Features.

Keith D Bohman, Cynthia Cohen, Harold C Sullivan, Blazej Zbytek, Amy L Adams. Emory University, Atlanta, GA

Background: Survivin, a member of the inhibitor-of-apoptosis (IAP) family of proteins, suppresses apoptosis and plays a role in the regulation of cell division. While not normally expressed in adult tissues, it is present in fetal development and is abnormally expressed in many types of cancer. The objective of our study was to compare the immunohistochemical expression of survivin in invasive breast carcinoma in two patient populations, one estrogen receptor (ER)-positive and the other ER/progesterone receptor/HER2 negative (triple negative (TN)). Additionally, we examined the correlation of survivin expression with other clinicopathologic factors including race, tumor size, grade, angiolymphatic invasion and lymph node metastasis.
Design: Tissue microarrays were constructed from representative formalin-fixed, paraffin-embedded tumor samples from 140 ER-positive and 145 TN-patients. Five micrometer sections were stained with antibody to survivin. The sections were evaluated for intensity of reactivity (0-3) and the percentage of reactive cells. A score was derived from the product of the intensity of reactivity multiplied by the percentage of reactive cells. Cases were categorized as having negative/weak (scores ≤100) or moderate/strong (scores>100) survivin expression.
Results: The expression of survivin overall and by subgroup is noted in Table 1. The ER-positive subgroup showed a stronger correlation with survivin expression than the TN group (p<0.0001). Tumors in Caucasian patients were significantly more likely to express survivin than those in African-American patients (p=0.0005), Table 2. There was no correlation of survivin expression with tumor size, grade, angiolymphatic invasion or lymph node metastasis.

Table 1
 Survivin Negative/WeakSurvivin Moderate/ Strong
Overall124 (43.5%)161 (56.5%)
ER-Positive (n=140)41 (29.3%)99 (70.7%)
Triple Negative (n=145)83 (57.2%)62 (42.8%)




Table 2
 Survivin Negative/WeakSurvivin Moderate/ Strong
Caucasian (n=158)56 (35.4%)102 (64.6%)
African-American (n=111)64 (57.7%)47 (42.3%)



Conclusions: Moderate to strong survivin expression was present in approximately 57% of invasive breast carcinomas overall. However, ER-positive tumors were significantly more likely to express survivin compared to those which are triple negative. Breast carcinomas in Caucasian patients were significantly more likely to express survivin than those in African-Americans. No correlation between survivin expression and tumor size, grade, angiolymphatic invasion or lymph node metastasis was noted.
Category: Breast

Monday, February 28, 2011 9:30 AM

Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 35, Monday Morning

 

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