Bcl-2 expression and triple negative profile in breast carcinoma Imen Kallel-Bayoudh • Hanen Ben Hassen • Abdelmajid Khabir • Noureddine Boujelbene • Jamel Daoud • Mounir Frikha • Tahia Sallemi-Boudawara • Sami Aifa • Ahmed Rebaı ¨ Received: 12 September 2010 / Accepted: 16 September 2010 Ó Springer Science+Business Media, LLC 2010 Abstract Many biomarkers for breast cancer prognosis have been proposed during the last two decades, among which HER2 and oestrogen receptors are of common use in routine clinical practice. However, in recent years, BCL2 has been recognized as an important prognostic parameter in human breast cancer, although its clinical utility is well established. The aim of this study was to examine the protein expression patterns of BCL2, HER2, oestrogen (ER) and progesterone receptors (PR) and to evaluate their correlation with survival and other prognostic parameters such as tumour size, histological grade and metastasis. We used a retrospective study including 84 Tunisian women with breast cancer. Immunohistochemistry was used to measure protein expression levels of several biomarkers. Association with conventional biopathological factors was analysed by SPSS (version13). The expression rates of BCL2, HER2, ER and PR were, respectively, 69, 62, 58.3 and 51.2%. In univariate analyses, BCL2 was highly cor- related with both PR (P \ 0.001) and ER (P = 0.006) and also with HER2 expression (P = 0.001). The triple nega- tive profile showed a significant association with SBR (P = 0.016) and BCL2 expression (P = 0.02). In multi- variate analyses, a significant association was maintained between BCL2 and both PR and ER (P = 0.02 and P = 0.004, respectively). Survival analysis showed that BCL2 expression was positively correlated with patients survival (P = 0.032). A Bayesian network analysis of all the variables confirmed the high value of BCL2 expression as a predictor of survival. As conclusion, BCL2 expression seems to be a very useful factor that should be in combi- nation with HER2 and ER in breast cancer prognosis. Keywords BCL2 expression Á Triple negative profile Á Prognosis Á Breast cancer Background BCL2 protein is a member of the bcl2 family that regulates apoptosis [1] and is expressed in normal glandular epi- thelium. Its tumourigenic potential has been demonstrated in animal models [2] and is supported by the finding of overexpression of BCL2 in a variety of tumours and in lymphomas in which BCL2 acts as an oncogene [3, 4]. It is overexpressed in 25–50% of breast cancers [5]. High expression of BCL2 is considered as a good prognostic factor in cancer since it has been associated with improved survival in patients with breast cancer [6–8]. High expression of BCL2 has been observed in ER-positive breast cancers as well as in progesterone receptor (PR)- positive breast cancers [6, 9, 10]. Electronic supplementary material The online version of this article (doi:10.1007/s12032-010-9694-x) contains supplementary material, which is available to authorized users. I. Kallel-Bayoudh Á H. B. Hassen Á S. Aifa Á A. Rebaı ¨(&) Bioinformatics and Signalling Unit, Centre of Biotechnology of Sfax, P.O. Box ‘1177’, 3018 Sfax, Tunisia e-mail: ahmed.rebai@cbs.rnrt.tn A. Khabir Á T. Sallemi-Boudawara Department of Pathology, Habib BOURGUIBA Hospital, Sfax, Tunisia N. Boujelbene Á J. Daoud Department of Radiotherapy, Habib BOURGUIBA Hospital, Sfax, Tunisia M. Frikha Department of Gynaecology, Hedi CHAKER Hospital, Sfax, Tunisia Med Oncol DOI 10.1007/s12032-010-9694-x