OBJETIVE: To investigate the prognostic value of the expression of cyclins D1 and D2, bcl2 and COX-2 on the outcome of very young breast cancer patients (below 35 years), and other clinicopathologic parameters.METHODS:In this study cyclins D1 and D2, bcl and COX-2 were determined by inmunohistochemistry in a cohort of 71 patients below 35 years of age with primary breast carcinoma.The correlation between cyclins D1 and D2, bcl 2 and COX-2 and clinicopathological parameters were assessed with the chi-square test.In a univariate survival analysis, the probability of disease-free survival was determined by the Kaplan-Meier method.Because the median survival was not reached in several subgroups, Kaplan-Meier estimates of the 5-year disease free survival rate and the 5-year overall survival rate are shown.RESULTS: Expression of cyclins D1 and D2, bcl and COX-2 was detected in 60%, 47.7%,62.5% and 67.2% of breast tumors, respectively.Cyclin D 1, D2 and bcl2 were significantly correlated with good prognostic clinicopathologic parameters, including smaller tumor size, negative margins, histological grade I, positive estrogen-receptor status, p53 and low Ki-67 expression.However, these factors didnt showed any influence on disease free survival (OR: 0, 94 for distant metastasis and 1, 05 for local relapses).In contrast, COX-2 overexpression was associated with larger tumor size, positive surgical margins, poor differentiation, high Ki-67 level, low expression for p53 and positive estrogen-receptor status.In a univariate survival analysis, there was a non-significant trend for a major risk for distant metastasis (OR: 2, 26) and local relapses (OR: 3, 7) in tumors that showed higher COX-2 expression.CONCLUSIONS: The current data suggest that increased expression of COX-2 may play a role in the progression of primary breast carcinoma in very young patients.The overexpression of cyclin D1 and D2 and bcl2 would have a potential role in identifying a subset of patients with good prognosis.Thus, the effect of these factors on prognosis in conjunction with conventional prognostic parameters such as histologic grade, stage, and hormone receptor status should be studied in large randomized controlled studies.