Expression of Cox-2 and Bcl-2 in Paget's Disease of the Breast

  • Alikanoglu, Arsenal Sezgin (Department of Pathology, Antalya Education and Research Hospital) ;
  • Yildirim, Mustafa (Department of Medical Oncology, Ministry of Health Batman Regional Goverment Hospital) ;
  • Suren, Dinc (Department of Medical Oncology, Ministry of Health Batman Regional Goverment Hospital) ;
  • Tutus, Birsel (Department of Pathology, Ministry of Health Finike Regional Goverment Hospital) ;
  • Kaya, Vildan (Department of Radiation Oncology, Suleyman Demirel University) ;
  • Topal, Cumhur Selcuk (Department of Pathology, Umraniye Education and Research Hospital) ;
  • Keser, Sevinc (Department of Pathology, Kartal Education and Research Hospital) ;
  • Karadayi, Ayse Nimet (Department of Pathology, Kartal Education and Research Hospital) ;
  • Kapucuoglu, Fatma Nilgun (Department of Pathology, Suleyman Demirel University) ;
  • Ayva, Sebnem (Department of Pathology, Baskent University) ;
  • Gunduz, Seyda (Department of Medical Oncology, Antalya Education and Research Hospital)
  • Published : 2015.03.04


Background: Paget's disease (PD) is a rare form of intraepithelial adenocarcinoma that involves breast and extramammarian tissues. It is often associated with ductal carcinoma in situ and/or invasive ductal cancer. Molecular pathways that play a role in development of Paget's disease are stil unclear. Expression patterns of Cox-2 and bcl-2 were therefore assessed. Materials and Methods: Patients with a histopathological diagnosis of Paget's disease were included in this study. Patient files were analysed retrospectively. Results: Invasive cancer was diagnosed in 35 (76.1%) of the patients, 7 (15.2%) had ductal carcinoma in situ and 4 (8.7%) patients had no associated neoplasm. Twenty four (52.2%) patients showed COX-2 expression in Paget cells whereas no expression was seen in 22 (47.8%) patients. No relation was found between COX-2 expression and the lesion underlying Paget's disease (p=0.518). Bcl-2 expression in Paget cells was found positive in 12 (26.1%) and negative in 27 (58,7%) cases. There was no relation between Bcl-2 expression and the lesion accompanying Paget's disease (p=0.412). No relation was observed between COX-2 expression and Bcl-2 expression (p=0.389). Conclusions: In breast cancer, COX-2 expression is associated with poor prognostic factors. As COX-2 expression increases the tendency to metastasize also increases. In our study we found a significantly high COX-2 expression in Paget's disease of the breast. We suggest that COX-2 expression and inflammatory processes may play a role in pathogenesis of the Paget's disease of the breast.


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