Cathepsin-D in primary breast cancer: prognostic evaluation involving 2810 patients

Br J Cancer. 1999 Jan;79(2):300-7. doi: 10.1038/sj.bjc.6690048.


There is controversy regarding the prognostic value of cathepsin-D in primary breast cancer. An increased level of cathepsin-D in tumour extracts has been found to be associated with a poor relapse-free and overall survival. Studies performed with immunohistochemistry or Western blotting have produced diverse results. We have analysed 2810 cytosolic extracts obtained from human primary breast tumours for cathepsin-D expression, and have correlated their levels with prognosis. The median follow-up of the patients still alive was 88 months. Patients with high cathepsin-D levels had a significantly worse relapse-free and overall survival, also in multivariate analysis (P < 0.0001). Adjuvant therapy which was associated with an improved prognosis in node-positive patients in univariate analysis, also significantly added to the multivariate models for relapse-free and overall survival. There were no statistically significant interactions between the levels of cathepsin-D and any of the classical prognostic factors in analysis for relapse-free survival, suggesting that the prognostic value of cathepsin-D is not different in the various subgroups of patients. Indeed, multivariate analyses in subgroups of node-negative and -positive patients, pre- and post-menopausal patients, and their combinations, showed that tumours with high cathepsin-D values had a significantly poor relapse-free survival, with relative hazard rates ranging from 1.3 to 1.5, compared with tumours with low cathepsin-D levels. The results presented here on 2810 patients confirm that high cytosolic cathepsin-D values are associated with poor prognosis in human primary breast cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Breast Neoplasms / chemistry
  • Breast Neoplasms / enzymology*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Cathepsin D / metabolism*
  • Cytosol / enzymology*
  • Disease-Free Survival
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Proteins / metabolism*
  • Prognosis
  • Receptors, Estrogen / analysis
  • Receptors, Progesterone / analysis
  • Recurrence
  • Regression Analysis


  • Neoplasm Proteins
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Cathepsin D