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Original scientific paper

Tumor Growth Fraction, Expression of Estrogen and Progesterone Receptors, p53, Bcl-2 and Cathepsin D Activity in Primary Ductal Invasive Breast Carcinoma and their Axillary Lymph Node Metastases

Jozo Kristek
Branko Dmitrović
Sven Kurbel
Kata Šakić
Zlatko Krajinović
Valerija Blažičević
Borislav Has
Ksenija Marjanović

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The aim of this paper is to determine similarities and differences between tumor cell subclones in cases of ductal invasive
breast carcinoma, and which occupy primary tumor and local axillary lymph metastases. The tumor growth fraction
evaluated by Ki-67 was analyzed along with the expression level of estrogen and progesterone receptors, protein p53,
proto-oncogene protein bcl-2 and cathepsin D in 60 patients. Metastatic lymph node in axilla has a higher growth fraction
of the tumor cells than the primary tumor (p=0.045), as well as the higher level of bcl-2 overexpression (p=0.014).
No statistically significant difference was found in the presence of immunohistochemically identified estrogen receptors
(p=0.161) and progesterone receptors (p=0.081) between the primary tumor and the metastatic lymph node in axilla.
Likewise, no difference was found between the immunohistochemical evaluation of p53 (p=0.356) and cathepsin D activity
(p=0.928). A higher growth fraction of the tumor cells and the higher level of bcl-2 overexpression in metastatic tumor
cells indicate the more aggressive cell subclones. This study does not support the routine testing of both primary tumor
and locoregional metastasis to evaluate the breast cancer hormone receptor status.


carcinoma, ductal, breast, receptors, estrogen, progesterone, Ki-67, bcl-2, p53, cathepsin D

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