Prognostic Significance of Survivin and Livin Expression in the Primary Breast Cancer and Their Lymph Node Metastases

Aim: To assess the prognostic significance of Survivin and Livin expression in invasive breast cancer and their lymph node metastases. Materials and Methods: The present series consists of archival samples from 78 women with invasive breast cancer diagnosed and treated during 2010-2014 at National Cancer Institute, Misurata, Libya. Tumor biopsies were analysed for expression of Survivin and Livin by immunohistochemistry, and different grading systems were tested for their expression. Results: In the cancer samples, a significant correlation was established between Survivin expression and site of the tumor (p=0.021), tumor recurrence (p=0.036), and unifocal tumor (p=0.001). Moreover, Her-2 negative tumors had higher Survivin expression than Her-2 positive tumors (p= 0.047). There were no associations between Survivin expression and histological grade, histological type, lymph node status, tumor stage, TNM classification, estrogen and progesterone receptors, distant metastases, chemotherapy, radiotherapy, hormone replacement, vascular invasion, surgical margin, positive family history. Livin expression in primary breast cancer showed a significant correlation (p=0.025) with positive family history, but no significant association with other clinicopathological parameters. In addition, we found that primary tumors showed higher Survivin expression (82%) compared with the lymph node metastases (34%), whereas Livin expression did not differ between the primary (71%) tumors and their metastases (84%). Conclusion: Survivin expression in primary breast cancer is significantly associated with several characteristics of favourable prognosis. Livin expression in primary breast cancer is significantly associated only with a positive family history of breast cancer.