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Breast cancer-specific survival was evaluated based on death from breast cancer; subjects who died of causes other than breast cancer were censored at time of death. Kaplan�CMeier curves and log-rank tests were used to compare survival distribution by protein expression, without adjustment and with total follow-up of 15?years. Risk of mortality, measured as hazard ratios (HR) and 95% confidence intervals (CI), adjusted for potential confounders, was calculated via Cox proportional hazards regression. Cases negative for protein expression were set as the reference in examining the association of the protein markers with survival. Potential confounders, included as covariates in the log-linear model, were age (Selleck GSK3 inhibitor of treatment (surgery only, ankyrin surgery plus other treatment and/or other treatment), and receptor status: ER (+/?), PR (+/?), and HER2 (+/?). Race/ethnicity was included as an additional covariate in a separate model (represented as indicator variables with Caucasians as the reference). Interaction was tested by the Wald test of cross-product terms of race/ethnicity and IGF-axis proteins entered into the models. Results Study population characteristics The 358 breast cancer cases were primarily 50?years and older (77%) and were comprised of Japanese Quisinostat (34%), Caucasians (29%), Native Hawaiians (16%), and other race/ethnic groups (21%) (Table?(Table1).1). Tumors were predominantly infiltrating ductal carcinomas (84%), of localized stage (68%), and of moderate or poor differentiation (73%). The majority of tumors expressed ER (72%) and PR (62%); 19% expressed HER2. Surgery combined with radiation with or without other therapy comprised the first course of treatment for 54% of cases. Fifty-one percent of cases were alive 17?years post-diagnosis. Of the 177 deaths, 66 were due to breast cancer. Age, stage, histology, grade, treatment, and receptor status (ER, PR, and HER2) did not vary across race/ethnic groups (data not shown). Table 1 Characteristics of invasive breast cancer cases IGF-axis protein expression and patient and clinical characteristics IGF1 was expressed in 30% of breast tumors, IGF1R in 26%, IGFBP2 in 74%, and IGFBP3 in 32% (Table?(Table2).2). The number of specimens excluded from the analysis because of missing results due to insufficient tissue, inadequate IHC results or equivocal IHC results are given in a footnote to the table. IGF1R was positively associated with expression of IGFBP2 (P?