Background: Triple negative breast cancer (TNBC) lacks the benefit of a
specific target therapy, so identification and evaluation of new therapeutic
agents is a high priority. Enhancer of zeste homolog 2 (EZH2) is a putative
stem cell marker involved in cell cycle regulation and was linked to aggressive
breast cancer. Cytokeratin 5/6 (CK5/6) is a basal cytokeratin used to define
basal like breast cancer. The aim: The aim of this work is to investigate the
expression of enhancer of EZH2 and CK5/6 in triple negative in comparison with
non-triple negative breast cancer using immunohistochemistry. Methods: EZH2 and
CK5/6 were retrospectively analyzed by immunohistochemistry in 44
paraffin-embedded specimens of breast cancer patients (20 cases of triple
negative and 24 of non- triple negative breast cancer). Results: TNBC was significantly
associated with higher grade (p=0.001), high tumor budding (p=0.029), syncytial
growth pattern (p=0.002), lymphovascular invasion (p=.0012), geographic
necrosis (p=0.003) and lymphocytic infiltrate (p=.001). EZH2 expression is
significantly associated with TNBC in comparison with non?TNBC (P=0.001). CK5/6
expression was observed in 75% of cases of TNBC in comparison to 30% of
non-TNBC with a statistically significant relation between CK5/6 expression and
TNBC (P=0.004). Among cases of TNBC, CK5/6 expression was significantly
associated with lymph node metastasis and high tumor budding. Conclusion:
Triple negative breast cancer has distinctive but not pathognomonic
morphological features. EZH2 was highly expressed in TNBC in comparison with
non-TNBC and this may explain the aggressiveness of triple negative breast
cancer. Basal breast cancer, identified by CK5/6 expression, showed
characteristic features in the form of high tumor budding, marked lymphocytic
infiltrate and higher incidence of lymph node metastasis. This finding
indicates that CK5/6 positive expression in TNBC is associated with poor
prognostic characteristics. - See more at:
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