Survivin and p53 expression in benign and malignant lesions of breast

Breast cancer is the most common malignancy in women, accounting for 14 % of all cancers in India; it accounts for < 1% of all cancer cases in men. Breast cancer is the leading cause of death worldwide. The study aims to assess the expression of p53 and Survivin in Fibroadenoma and Invasive carcinoma of no special type and its prognostic importance.A total number of 75 cases are included in the study, out of which 34 are reported by two histopathologists as invasive carcinoma NST (ductal) and 41 reported as Fibroadenoma. All the cases included in the study are females. Immunohistochemistry for p53 and Survivin performed in both the groups with positive and negative controls. Cytoplasmic or nuclear IHC expression for Survivin is considered to be positive. Whereas, nuclear positivity is considered for p53. A semi quantitative scoring system performed consisting of intensity and % of positive cells. The expression of Survivin and p53 is found to be high in IDC, 79% and 85% respectively. The correlation is found to be significant (p value = 0.002, Spearman Rho correlation). However, the expression of Survivin is seen in one third of all the cases of Fibroadenoma (37.5%) and p53 expression is expectedly low, seen in 12% cases. Over expression of Survivin in IDC patients compared to benign cases is found to be correlated with p53 expression. Though Survivin is likely to contribute to apoptosis resistance, its expression is found to confer resistance to chemotherapy and radiotherapy in IDC. Henceforth, Survivin over expression along with p53 in invasive breast carcinoma defining overall poor prognosis and low survival rates.