Ademuyiwa FO, Thorat MA, Jain RK, Nakshatri H, Badve S.. Expression of Forkhead-box protein A1, a marker of luminal A type breast cancer, parallels low Oncotype DX 21-gene recurrence scores. Mod Pathol 23: 270-275

Department of Medicine, Indiana University, School of Medicine, Indianapolis, IN 46202, USA.
Modern Pathology (Impact Factor: 6.19). 11/2009; 23(2):270-5. DOI: 10.1038/modpathol.2009.172
Source: PubMed


The Oncotype DX assay is one of the molecular tests that provide predictive and prognostic information to breast cancer patients with estrogen receptor (ER)-positive and node-negative disease. This study evaluates the association of Forkhead-box protein A1 (FOXA1) and GATA-binding protein 3 (GATA3) expressions with Oncotype DX recurrences scores in 77 cases of patients with ER-positive node-negative breast carcinomas diagnosed at Indiana University. The data were correlated with patient age, tumor size, histologic type, Scarff-Bloom-Richardson score, histologic grade, and progesterone receptor status. The median FOXA1 and GATA3 scores were 240 and 200, respectively. The Oncotype DX recurrence scores were low in 57%, intermediate in 30%, and high in 13% of cases. FOXA1 expression correlated negatively with Oncotype DX recurrence scores (P=0.004), and histologic type (P=0.0004). Oncotype DX recurrences score also correlated negatively with progesterone receptor (P=0.035) with 100% of progesterone receptor-negative cases having high or intermediate Oncotype DX scores. FOXA1 and GATA3 expressions correlated positively (P=0.014). The correlation between FOXA1 expression and Oncotype DX recurrence scores remained significant after adjusting for multiple comparisons and controlling for confounders such as histological type, grade, and progesterone receptor. A statistically significant correlation between the Oncotype DX recurrence scores and FOXA1 expression in our diverse cohort of ER-positive breast cancer patients was observed. We propose that this may represent a more cost-effective strategy to further risk stratify patients with good prognosis in whom chemotherapy may be omitted. To confirm these findings, further studies in a larger cohort of patients are warranted.

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Available from: Sunil Badve, Mar 06, 2015
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    • "By contrast, in breast cancer, there is a clear association between high FOXA1 expression and a better survival (Habashy et al. 2008). In fact, the Oncotype DX test for breast cancer prognosis shows a negative and significant correlation between FOXA1 expression and recurrence (Ademuyiwa et al. 2010). In the future, studies focused on these tissue-specific properties of FOXA1 will be instrumental for our understanding of hormone-regulated cancers. "
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    • "The only ERBB2-amplified sample negative with HerceptTest (T11348) was luminal A. Unfortunately, no sufficient material (T11348) associated with a correct morphology was available to confirm its ERBB2 amplification status by using silver in situ hybridization (SISH, Ventana). The IHC pattern of this sample showing also FOXA1 positivity was in agreement with its luminal A phenotype [40,41], suggesting that no mismatching had occurred for this case. "
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