High Ep-CAM expression is associated with poor prognosis in node-positive breast cancer

Breast Cancer Res Treat. 2004 Aug;86(3):207-13. doi: 10.1023/B:BREA.0000036787.59816.01.


Previous studies in small series of patients with invasive breast cancer suggested a prognostic value of Ep-CAM overexpression in primary tumor tissue. To corroborate these findings, we performed a retrospective analysis of Ep-CAM expression using a tissue microarray containing tissue specimens from a large patient set. Ep-CAM expression was evaluated by immunohistochemistry in breast cancer tissue from 1715 patients with documented raw survival data. High level Ep-CAM expression (overexpression) was found in 41.7% of tumor samples, low level expression was found in 48.0% and no expression in 10.3% of tumor samples. Ep-CAM expression predicted poor overall survival in this patient cohort (p < 0.0001). Overall survival decreased significantly with increasing Ep-CAM expression. However, in this patient sample Ep-CAM expression was not an independent prognostic marker by multivariate analysis. Subgroup analysis revealed that Ep-CAM expression was a prognostic marker in node-positive (p < 0.0001) but not in node-negative (p = 0.58) breast cancer patients. Intriguingly, Ep-CAM expression was predictive for a dismal prognosis in patients receiving adjuvant cytotoxic (p = 0.03) or hormonal therapy (p < 0.0001) but not in untreated patients (p = 0.41). In summary, this study provides strong evidence that expression of Ep-CAM is a powerful marker of poor prognosis in node-positive invasive breast carcinoma and a potential predictive marker of sensitivity to adjuvant hormonal and/or cytotoxic treatment modalities.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antigens, Neoplasm / biosynthesis*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / pathology*
  • CD3 Complex
  • Carcinoma / drug therapy
  • Carcinoma / genetics*
  • Carcinoma / pathology*
  • Cell Adhesion Molecules / biosynthesis*
  • Epithelial Cell Adhesion Molecule
  • Female
  • Gene Expression Profiling*
  • Humans
  • Immunohistochemistry
  • Lymphatic Metastasis*
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome


  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • CD3 Complex
  • Cell Adhesion Molecules
  • Epithelial Cell Adhesion Molecule