p53 status identifies two subgroups of triple-negative breast cancers with distinct biological features

Objective: Despite the clinical similarities triple-negative and basal-like breast cancer are not synonymous. Indeed, not all basal-like cancers are negative for estrogen receptor, progesterone receptor and HER2 expression while triple-negative also encompasses other cancer types. P53 protein appears heterogeneously expressed in triple-negative breast cancers, suggesting that it may be associated with specific biological subgroups with a different outcome. Methods: We comparatively analyzed p53 expression in triple-negative tumors from two independent breast cancer case series (633 cases from the University of Ferrara and 1076 cases from the University of Nottingham). Results: In both case series, p53 protein expression was able to subdivide the triple-negative cases into two distinct subsets consistent with a different outcome. In fact, triple-negative patients with a p53 expressing tumor showed worse overall and event-free survival. Conclusions: The immunohistochemical evaluation of p53 expression may help in taming the currently stormy relationship between pathological (triple-negative tumors) and biological (basal breast cancers) classifications and in selecting patient subgroups with different biological features providing a potentially powerful prognostic contribution in triple-negative breast cancers.