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Breast Cancer Research

Open Access

Cyclo-oxygenase-2 expression is associated with poor clinical outcome after doxorubicin-based chemotherapy in node-positive breast cancer: integration of tissue microarray

  • SH Han1,
  • JS Kim2,
  • SS Jung2 and
  • BJ Song2
Breast Cancer Research20057(Suppl 1):P1

Published: 27 May 2005


Breast CancerOverall SurvivalHistologic GradeTissue MicroarrayPoor Clinical Outcome


We performed this study to evaluate the frequency and clinical implications of cyclo-oxygenase (COX)-2 expression in clinical breast cancer.


COX-2 expression was analyzed on tissue microarray (TMA) of 178 node-positive patients treated with doxorubicin-based adjuvant chemotherapy by immunohistochemistry (IHC).


COX-2 was over-expressed in 70 (39.3%) out of 178 invasive breast cancers. COX-2 expression was significantly increased in undifferentiated tumor with high S-phase fraction. COX-2 expression appeared to be increased in HER2-amplified tumors but the difference was not statistically significant. There was no significant association between COX-2 over-expression and other clinical and biologic profiles such as tumor size, histologic grade, and oestrogen receptor (ER) expression. Disease-free survival (DFS) and overall survival (OS) of the patients with COX-2 expressing tumor was significantly decreased compared with the patients with COX-2 negative tumor (P = 0.009 for DFS, P = 0.011 for OS). COX-2 expression and histologic grade were significant prognostic factors for DFS and OS in multivariate analysis.


The intimate association of COX-2 expression with increased S-phase and high histologic grade, together with poor clinical outcomes for COX-2 expressing tumors, indicates that COX-2 expression represents a highly aggressive phenotype of breast cancer.

Authors’ Affiliations

Department of Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea


© BioMed Central 2005