Abstract
Background & objectives Genetic instability is frequent in tumour cells and might occur due to an imbalance of homologous recombination (HR). HR is a crucial mechanism of DNA double-strand break (DSB) repair that depends on the formation and resolution of Holliday junctions for genomic stability maintenance. The SMC6 complex with SMC5 is involved in DSB repair. We sought to investigate the association between SMC6 expression, genomic instability, and prognosis of breast cancer. Methods This was an observational retrospective cohort study. We assessed SMC6 expression and copy number variation (CNV) data measured by qRT-PCR and whole-genome comparative genomic hybridization in 33 women with breast cancer who are non-carriers of BRCA1/BRCA2 mutations. According to nuclear staining, the SMC6 protein expression was evaluated on a tissue microarrayer containing 481 samples classified as SMC6low (negative/weak) or SMC6high (moderate/strong). Results SMC6low tumours tend to show higher CNV. SMC6high group presented poorer disease-free survival than the SMC6low group (P=0.050), mainly for the luminal subtype (P=0.005). SMC6low/ERpos were protective biomarkers for recurrence. Interpretation & Conclusions There is a possible association between SMC6 expression and relapse of breast cancer, also suggesting that SMC6 abnormal expression may indicate tumour genetic instability in breast cancer.