Background Basal-like breast cancers, originally recognized by gene expression profiling, can be clinically identified using immunohistochemical (IHC) definitions that require estrogen receptor (ER) negativity. However, some basal cases are ER positive and are mistakenly considered to be luminal by standard IHC approaches, leading to suboptimal treatment choices. Nestin, an intermediate filament expressed in many stem cells, is a recently identified positive marker of basal-like pheno - type independent of ER status. In this study, we evaluated its clinical associations and prognostic capacity in a large breast cancer cohort. Methods A tissue microarray series of clinically annotated invasive breast cancers with 12.6-year median follow-up was assessed for nestin expression by IHC. Kaplan–Meier and Cox regression models were used to evaluate the prognostic sig- nificance of nestin status, for the primary endpoint of breast cancer-specific survival (BCSS). Results Among 3641 cases interpretable for nestin by IHC, positive staining was found in 371 cases (10%) and was signifi - cantly associated with poor prognostic factors including other markers of basal-like differentiation. Patients with nestin- positive tumors had a significantly lower 10 year BCSS (HR 1.97, 95% CI 1.62–2.40; P < 0.001). Importantly, within the large group of 2323 ER+ cases, nestin positivity identified a subgroup of
Breast Cancer Research and Treatment – Springer Journals
Published: Nov 20, 2017
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