# Assessment of HIF-1α and c-MYC in Breast Carcinoma and Their Association With Clinicopathological Parameters: A Cross-Sectional Study

## TL;DR

This study examines the role of HIF-1α and c-MYC in breast cancer and their links to cancer characteristics and progression.

## Contribution

The study provides new insights into the clinicopathological significance of HIF-1α in breast cancer.

## Key findings

- HIF-1α expression was significantly correlated with tumor grade.
- No significant association was found between c-MYC and clinicopathological parameters.
- HIF-1α may serve as a potential therapeutic target for aggressive breast cancer.

## Abstract

Introduction: Breast cancer is one of the most common malignancies. Early diagnosis and prevention usually lead to a good prognosis and a better survival rate. Despite significant advancements in the prevention, there is still a lack of effective therapies against particular subtypes. A complex interplay takes place between HIF-1α (hypoxia-inducible factor 1-alpha) and MYC, which reprograms the metabolism of cancer cells and promotes tumour cell growth, progression, and therapy resistance.

Aim: To study the immunohistochemical expression of HIF-1α and c-MYC in breast carcinoma cases and their correlation with clinicopathological parameters like age, tumour grade, tumour stage, nodal status and molecular subtypes, lymphovascular invasion, and perineural invasion, and their association with each other.

Materials and methods: A total of 61 cases of histopathologically confirmed invasive breast carcinoma were studied. Clinical and paraclinical characteristics were recorded. Immunohistochemistry for HIF-1α and c-MYC was done. HIF-1α expression was categorised as negative, low, and high, while c-MYC expression was scored as negative and positive. The data were analysed using univariate description and bivariate analysis, applying the chi-square test.

Result: The age ranged from 31 to 81 years, with a mean of 52.9 ± 12.9 years. HIF-1α expression was significantly correlated with the grade of the tumour (p = 0.035). However, no significant association was obtained between HIF-1α and age, lymphovascular invasion (LVI), perineural invasion (PNI), tumour stage, nodal status, proliferative index, and molecular subtypes. Our study did not find any significant correlation between c-MYC expression with histologic grade, LVI, PNI, tumour stage, nodal status, molecular subtypes, and HIF-1α expression.

Conclusion: An increase in HIF-1α expression correlated with aggressive behaviour of cancer and a higher likelihood of metastatic tumours. HIF-1α inhibitors can be considered as a newer therapeutic target.