Prostate-specific antigen value as a marker in breast cancer

The immunoexpression of prostate-specific antigen in breast cancers has been well established, but the role of this extra-prostate PSA appears to be a complex, poorly understood and of doubtful prognostic value. In this context, our aim was to evaluate PSA in breast carcinomas and to compare the results with several established prognostic markers of breast cancer: estrogen and progesterone receptors status, HER2/neu status, histological type of tumor, grade of differentiation, stage, tumor size, nodal and menopausal status. We have immunohistochemically assessed 53 breast carcinomas for PSA, ER, PR and oncoprotein HER2/neu status. The relationship between the clinical and histopathological markers was analyzed by chi-square test. In the present study PSA was expressed in 60.3% of cases, and we have found a significant correlation with the histological type and HER2/neu negative status in premenopausal women. No statistically significant difference was found between PSA positivity and menopausal status of the patients, nodal status, estrogen and progesterone receptors, HER2/neu status in postmenopausal patients, tumor size or histological grade. We conclude that in our study PSA can not be considered as a valuable independent prognostic factor in breast carcinoma. As long as the majorities of PSA positive carcinomas were small in size, early stage, better and moderately differentiated, HER2/neu negative and 70% of ER/PR positive carcinomas expressed PSA, it might be useful as a marker for a subset of breast cancers with better prognosis, which could respond to endocrine therapy, in correlation with other prognostic markers.