p53 mutation, deprivation and poor prognosis in primary breast cancer |
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Authors: | L Baker P R Quinlan N Patten A Ashfield L-J Birse-Stewart-Bell C McCowan J-C Bourdon C A Purdie L B Jordan J A Dewar L Wu and A M Thompson |
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Institution: | 1.Department of Surgery and Molecular Oncology, Dundee University, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK;2.Roche Molecular Systems, 4300 Hacienda Drive, Pleasanton, CA 94588, USA;3.Health Informatics Centre, Dundee University, Mackenzie Building, Ninewells Hospital and Medical School, Dundee DD2 4BF, UK;4.Department of Pathology, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK;5.Department of Oncology, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK |
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Abstract: | Background: The deprivation gap for breast cancer survival remains unexplained by stage at presentation, treatment, or co-morbidities. We hypothesised that p53 mutation might contribute to the impaired outcome observed in patients from deprived communities.Methods: p53 mutation status was determined using the Roche Amplichip research test in 246 women with primary breast cancer attending a single cancer centre and related to deprivation, pathology, overall, and disease-free survival.Results: p53 mutation, identified in 64/246 (26%) of cancers, was most common in 10 out of 17 (58.8%) of the lowest (10th) deprivation decile. Those patients with p53 mutation in the 10th decile had a significantly worse disease-free survival of only 20% at 5 years (Kaplan–Meier logrank χ2=6.050, P=0.014) and worse overall survival of 24% at 5 years (Kaplan–Meier logrank χ2=6.791, P=0.009) than women of deciles 1–9 with p53 mutation (c.f. 56% and 72%, respectively) or patients in the 10th decile with wild-type p53 (no disease relapse or deaths).Conclusion: p53 mutation in breast cancer is associated with socio-economic deprivation and may provide a molecular basis, with therapeutic implications, for the poorer outcome in women from deprived communities. |
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Keywords: | p53 primary breast cancer socio-economic deprivation overall survival disease-free survival |
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