FBXW7 is a cell cycle regulatory gene that ubiquitinates positive cell cycle regulators such as c-Myc and cyclin E, allowing for cell cycle exit. Defects in the FBXW7 gene that lead to cell cycle re-entry and expedite the G1-S transition is thought to be one of the causes of cancer development. However, its clinical importance for breast cancer patients remains undetermined. This prompted us to investigate its expression level in breast cancer patients to establish its clinical significance. The expression level of FBXW7 mRNA was assessed in 186 cases of primary invasive breast cancer. Correlations between FBXW7 mRNA expression and clinicopathological factors, prognoses and immunohistochemical expression levels of Ki-67, FBXW7, c-Myc and cyclin E were analyzed. In vitro investigation of FBXW7 gene silencing in a breast cancer cell line was conducted. FBXW7 mRNA was expressed at significantly lower levels in patients with high histological grade and hormone receptor-negative tumors. Patients with lower FBXW7 mRNA expression had a poorer prognosis for breast cancer-specific survival than those with higher expression. A high Ki-67 labeling index and positive cyclin E protein expression were significantly correlated with lower FBXW7 mRNA expression. In vitro, silencing FBXW7 enhanced expression of c-Myc and cyclin E proteins and upregulated both cell proliferation and G1-S transition. In breast cancer, reduced FBXW7 mRNA expression may have independent prognostic potential through the enhanced function of cell cycle regulatory proteins. (Cancer Sci 2011; 102: 439-445) R ecent studies have revealed that the ubiquitin-proteasome system plays many important roles in human carcinogenesis, such as in cell cycle progression, apoptosis, signal transmission and DNA repair. Frequent deregulation of E3 ligase components in breast cancer has led to their investigation as oncogenes or tumor suppressor genes. Major examples are the amplification and overexpression of Mdm2 and Skp2, mutation of BRCA1 in familial breast cancer and, more recently discovered, mutation and loss of expression of FBXW7 (F-box and WD repeat domain-containing 7).(1,2) FBXW7 is a component of SCF (complex of SKP1, CUL1 and F-box protein)-type ubiquitin ligases and regulates positive cell cycle regulators such as c-Myc, cyclin E, c-JUN, Aurora A and Notch, molecules commonly implicated in many cancers (3) including breast cancer.(4,5) c-Myc is a transcription factor and has a crucial role in deciding whether or not mammalian cells divide. Cyclin E coordinates S-phase entry from either G1 or quiescence (G0), and constitutive expression of cyclin E leads to genomic instability. One notable function of FBXW7 is induction of cell cycle exit (to G0-phase) by c-Myc degradation, whereas cell cycle re-entry (G0 to G1) is regulated by p27 and its F-box regulator Skp2. Therefore, altered expression of FBXW7 is hypothesized to cause carcinogenesis and cancer development. (6,7) FBXW7 was first linked to carcinogenesis when mutations in FBXW7 were found in the brea...