Association of Bcl-2 expression with prognostic indicators in breast cancer

Background: The Bcl-2 protein is a member of the bcl family of proteins, which play a key role in the cell apoptosis process. Its tumorigenic potential has been established long ago in animal experimental models, and was subse¬quently supported by the finding of its overexpression in a variety of human tumours. Bcl-2 has been suggested as a prognostic marker for the neoplastic diseases; new evidence keeps arising providing further support to this finding. Aim: This study investigated the association of Bcl-2 expression with prognostically important clinicopathological fea¬tures in breast carcinoma in the Greek population. Methodology: Immunohistochemical assessment of Bcl-2 was conducted in a case series of 100 surgically resected primary breast carcinomas from November 2022 to July 2023 and the association of Bcl-2 with the grade of histological differentiation and Lymph nodes pN was statistically inves¬tigated. Results: The histological grade profile of the studied samples was: Grade III (24%), Grade II (62%), Grade I (14%). High (score 3+) Bcl-2 expression was found in 65% of cases, moderate (score 2+) expression in 12%, low (score 1+) in 4%, while negative expression was shown in 19% of the samples. A statistically significant inverse association between Bcl-2 expression and the grade of histological differentiation was detected (Phi=-0.850, p=< 0.0001). Bcl-2 expression was also inversely associated with Lymph nodes pN stage (p=0.001). Conclusion: The observed association of immunohistochemical Bcl-2 expression with clinicopathological characteristics which are known prognositc indicators for breast cancer (grade and pN stage) provides confirmatory evidence to the potential important prognostic value of this marker in breast cancer. Future investigations should incorporate Bcl-2 expression in multivariate prediction models to weigh its value in the clinical management of breast cancer.