Can Caspase-3 act as a potential prognostic biomarker in breast cancer? - A retrospective pilot study in central India

Background: Caspase-3 is involved in the apoptosis induced by many agents, including antineoplastic drugs in cancers. Loss of caspase-3 expression and activity has been reported in primary human breast cancers. It is suggested that it might promote tumour development by preventing and reducing senescence. It was a retrospective observational pilot study aimed to evaluate the prognostic potential role of caspase-3 in breast cancer patients. Method: It was a retrospective observational pilot study in which fifty breast cancer patients were enrolled. Haematoxylin and eosin-stained slides of the cases were screened to obtain the best paraffin block for IHC, on which immunohistochemical expression of caspase-3 marker was done and studied. It was correlated with the known prognostic markers of breast cancer. Results: Out of 21 cases with moderate caspase-3 staining, 85.7% cases were grade III and 14.2% were grade II. From 16 cases with strong caspase-3 staining, 75% cases were grading III followed by 25% cases of grade II. There was no significant correlation between caspase-3 staining with histological grade, size of tumour, lymph node involvement, ER, PR and Her2/neu status (p=0.68, 0.24, 0.20, 0.68, 0.45 and 0.11 respectively). Correlation of survival was significantly associated with lymph node involvement (p=0.01) while it was insignificant for tumour size and histological grade (p=0.36 and 0.42 respectively). Conclusion: The survival of breast cancer patients was correlated only with lymph node metastasis. It was better with smaller number of lymph node involvement. While, Caspase-3 did not have any direct association with prognostic markers of breast carcinoma like tumour size, grade of tumour, lymph node and ER, PR and HER-2/neu status. It can be probably used as a prognostic biomarker in future if bigger study is able to establish the significance in breast cancer.