Main Article Content
Autocrine effect; Breast Cancer; Carcinogenesis; COX-2 expression; Paracrine effect.
Background: Breast carcinoma is the most common malignant tumor and leading cause of cancer related death in women worldwide. Apart from traditional markers, estrogen receptor, progesterone receptor and Her-2neu, which are important for prognostication and staging purposes, a novel marker cyclooxygenase-2 (COX-2) is being studied extensively. We intend to study the spectrum of COX-2 expression in normal breast tissue, ductal carcinoma in situ (DCIS) adjacent to invasive cancer, and in invasive cancer and compare COX-2 expression with histological prognostic parameters and hormone receptor status.
Methods: The present study is a prospective study that was conducted in the department of Pathology, SGT Medical College and Hospital, Gurugram (2019-2020). Fifty patients, aged between 21 and 70, suffering from primary breast cancer constituted the study group. Various histological prognostic parameters were assessed. Immunohistochemical profile of the tumor was assessed. COX-2 score was correlated with various clinicopathologic parameters.
Results: Among the total of 50 patients suffering from invasive breast carcinoma, 94 percent (47/50) of cases showed the same COX-2 expression level in normal breast epithelium and corresponding tumor areas and this correlation was statistically significant. The correlation between the level of COX-2 expression in tumor and DCIS was highly significant.
Conclusion: Inhibition of COX-2 may represent a potential target for preventing breast cancer oncogenesis and as an adjuvant treatment following surgery to reduce local recurrence.
2. Annual Reports. 1982-2008. National Cancer Registry. New Delhi: Indian Council of Medical Research; 1985-2010. [Available from: https://ncdirindia.org/ncrp/Annual_Reports.aspx
3. Weigel MT, Dowsett M. Current and emerging biomarkers in breast cancer: prognosis and prediction. Endocr Relat Cancer. 2010;17:R245-62.
4. Subbaramaiah K, Dannenberg AJ. Cyclooxygenase 2: a molecular target for cancer prevention and treatment. Trends Pharmacol Sci. 2003;24:96-102.
5. Glover JA, Hughes, Cantwell MM, Murray LJ. A systematic review to establish the frequency of cyclooxygenase-2 expression in normal breast epithelium, ductal carcinoma in situ, microinvasive carcinoma of the breast and invasive breast cancer. Br J Cancer. 2011;105:13-7.
6. Ranger GS, Jewell A, Thomas V, Mokbel K. Elevated expression of cyclooxygenase-2 in breast cancer and ductal carcinoma in situ has no correlation with established prognostic markers. J Surg Oncol. 2004;88:100-3.
7. Shim V, Gauthier ML, Sudilovsky D, Mantei K, Chew KL, Moore DH, et al. Cyclooxygenase-2 expression is related to nuclear grade in ductal carcinoma in situ and is increased in its normal adjacent epithelium. Cancer Res.2003;63: 2347–50.
8. Leo C, Faber S, Hentschel B, Hockel M, Horn LC. The status of cyclooxygenase-2 expression in ductal carcinoma in situ lesions and invasive breast cancer correlates to cyclooxygenase-2 expression in normal breast tissue. Ann Diagn Pathol. 2006;10:327-32.
9. Ristimaki A, Sivula A, Lundin J, Lundin M, Salminen T, Haglund C, et al. Prognostic significance of elevated cyclooxygenase-2 expression in breast cancer. Cancer Res. 2002;62:632-5.
10. Takeshita E, Osanai T, Higuchi T, Soumaoro LT, Sugihara K. Elevated cyclooxygenase-2 expression is associated with histological grade in invasive ductal breast carcinoma. J Med Dent Sci. 2005;52:189-93.
11. Half E, Tang XM, Gwyn K, Sahin A, Wathen K, Sinicrope FA, et al. Cyclooxygenase-2 expression in human breast cancers and adjacent ductal carcinoma in situ. Cancer Res. 2002;62:1676-81.
12. Boland GP, Butt IS, Prasad R, Knox WF, Bundred NJ. COX-2 expression is associated with an aggressive phenotype in ductal carcinoma in situ. Br J Cancer. 2004;90:423-9.
13. Perrone G, Santini D, Vincenzi B, Zagami M, La Cesa A, Bianchi A, et al. COX-2 expression in DCIS: correlation with VEGF, HER-2/neu, prognostic molecular markers and clinicopath-ological features. Histopathol. 2005; 46:561-8.
14. Shim JY, An HJ, Lee YH, Kim SK, Lee KP, Lee KS, et al. Overexpression of cyclooxygenase-2 is associated with breast carcinoma and its poor prognostic factors. Mod Pathol. 2003;16:1199-204.