p53 mutation, deprivation and poor prognosis in primary breast cancer

Background: The deprivation gap for breast cancer survival remains unexplained by stage at presentation, treatment, or co-morbidities. We hypothesised that p53 mutation might contribute to the impaired outcome observed in patients from deprived communities. methods: p53 mutation status was determined using the Roche Amplichip research test in 246 women with primary breast cancer attending a single cancer centre and related to deprivation, pathology, overall, and disease-free survival. results: p53 mutation, identified in 64/246 (26 of cancers, was most common in 10 out of 17 (58.8 of the lowest (10th) deprivation decile. Those patients with p53 mutation in the 10th decile had a significantly worse disease-free survival of only 20% at 5 years (Kaplan?Meier logrank chi2=6.050, P=0.014) and worse overall survival of 24% at 5 years (Kaplan?Meier logrank chi2=6.791, P=0.009) than women of deciles 1?9 with p53 mutation (c.f. 56% and 72 respectively) or patients in the 10th decile with wild-type p53 (no disease relapse or deaths). conclusion: p53 mutation in breast cancer is associated with socio-economic deprivation and may provide a molecular basis, with therapeutic implications, for the poorer outcome in women from deprived communities.