A Comparative Clinical Study in Patients with Breast Cancer with and Without P53 Expression

Background: The most common genetic change in human neoplasia is P53. Furthermore, the most common visceral cancer among Iranian women is breast cancer. Several studies have reported that breast cancer associated with mutations in P53 tends to be more aggressive and presents different prognoses and clinical outcomes. Objectives: The aim of current study was to evaluate and compare the prognostic factors and clinical outcomes related to TP53 expression in Iranian women with breast cancer. Methods: In a longitudinal study conducted from 2003 to 2017, data were extracted from the Cancer Research Center's database for 801 breast cancer patients. These patients were categorized into two groups: Those with mutated P53, comprising 300 individuals, and those wild type P53 expression, totaling 501 individuals. The clinical outcomes and prognostic factors for these two groups were subsequently assessed and compared. Results: Among the total samples, patients with mutated P53 accounted for 37.5%, while those with wild P53 made up 62.5%. The mean ages for these groups were 44.2 years (SD = 9.4) for the mutated P53 group and 47.7 years (SD = 10.9) for the wild P53 group, with a statistically significant difference (OR: 2.01, 95% CI: 1.47 - 2.74, P < 0.0001). Patients exhibiting mutated P53 factors showed a higher prevalence of advanced disease stages (OR: 1.44, 95% CI: 1.07 - 1.95, P = 0.0162), lymph node involvement (OR: 1.55, 95% CI: 1.14 - 2.12, P = 0.0047), positive lymphovascular invasion (OR: 1.40, 95% CI: 1.03 - 1.90, P = 0.0296), premenopausal status (OR: 1.36, 95% CI: 1.02 - 1.82, P = 0.0339), negative Estrogen receptor status (OR: 1.35, 95% CI: 1.01 - 1.81, P = 0.0374), and positive HER2 status (OR: 1.37, 95% CI: 1.00 - 1.87, P = 0.0494) compared to those with wild P53. In terms of survival rates, the five-year disease-free survival was 81% in the mutated P53 group and 86.4% in the wild P53 group (HR: 1.49, 95% CI: 1.01 - 2.19, P = 0.0413), while the five-year overall survival rates were 70% and 76.8%, respectively (HR: 1.42, 95% CI: 1.03 - 1.96, P = 0.0323). Conclusions: It appears that patients without P53 expression have better clinical outcomes and more favourable prognostic factors compared to patients with P53 expression.