Somatic mutations in the TP53 gene are the most frequently observed genetic alterations in human malignancies, including breast cancer, which is one of the leading causes of death among women in Brazil. In our study, we determined the frequency and the pattern of TP53 mutations in malignant breast tumors from 120 patients living in Rio de Janeiro, Brazil. TP53 mutations were found in 20% of the tumors, which contained a diversity of mutation types: missense (62.5%), nonsense (8.3%), silent (4.2%), intronic (12.5%), insertion (4.2%) and deletion (8.3%). Of a total of 15 missense mutations, 4 were observed at Arg248 and 2 at Cys242, which are directly involved in DNA binding and in zinc binding, respectively. A subgroup of 51 patients was analyzed with respect to the relation between the presence of TP53 mutations and classical risk factors and with tumor and patient characteristics. For this analysis, we used logistic regression and, in order to obtain more precise confidence intervals, they were recalculated using a bootstrap resampling technique. Our results demonstrate that these mutations are not statistically associated with the risk factors or the patients' characteristics. However, the presence of TP53 mutations is strongly associated with the aggressiveness of the tumors, measured by Elston classification (OR ؍ 11.97 and 95% CI of 2.24 -307.05). This finding is in agreement with previous studies, which report the presence of TP53 mutations in tumors with poor prognosis. This correlation between tumor aggressiveness and TP53 mutations could be a crucial variable for the treatment and prognosis of breast cancer. © 2002 Wiley-Liss, Inc.
Key words: TP53 gene; breast cancer; risk factors; clinicopathologic features; Rio de Janeiro, Brazil; Elston gradeBreast cancer is one of the leading causes of death among women in Brazil. The Brazilian expected mortality rate for 2001 is 9.9 women per 100,000, whereas the highest incidence was estimated to be in the State of Rio de Janeiro: 82 women per 100,000. 1 The etiology of breast cancer is rather complex and, although 10 -15% of the patients have a family history of the disease, only a small proportion can be explained by mutations in genes such as BRCA1 and BRCA2.The different geographic distribution of cases and evidence from migration studies suggest that some environmental and/or lifestyle factors may be related to the development of breast cancer. 2 Reproductive history, family history of breast cancer, cigarette smoking and alcohol consumption are generally cited as risk factors of breast cancer. However, how these factors contribute to trigger the molecular mechanisms of tumor initiation and progression is not completely understood. 3 Mutations in the tumor suppressor gene, TP53, are the most common genetic alterations seen in human cancer. 4 This gene encodes a 393 amino acid nuclear phosphoprotein that acts as a transcription factor and is implicated in nearly all pathways involved in cell proliferation control: modulation of cell-cycle progression, apopto...