The purpose of the study was to determine the role of COX-2 in the development and progression of molecular subtypes of invasive ductal breast cancer by comparing COX-2 expression level between different clinical and pathological prognostic parameters. Materials and methods. We studied 193 cases of invasive ductal breast cancer using comprehensive morphological, including immunohistochemical methods. General histological processing of samples was performed according to standard methods. Immunohistochemical studies for COX-2, ER, PR, c-erbB2, Ki-67 were performed according to the manufacturer's protocol with the control of samples. The grade of malignancy was determined according to the modified scheme of P. Scarff, H. Bloom and W. Richardson. COX-2 expression level was quantified using the Histoscore counting system in 86 cases. Immunoreactive index was defined as the product of positive cells and color intensity with a value from 0 to 12. The distribution of tumors with weak or strong expression of COX-2 was determined at the level of limit 6. Comparison of COX-2 expression at different clinical and pathological parameters was evaluated using the criterion Pearson χ2. For all types of analysis, differences were considered significant at p <0.05. Results and discussion. Immunohistochemical studies showed overexpression of COX-2 tumor cells in 53.49 [42.95-63.87] % of cases of invasive ductal breast cancer, mainly in premenopausal patients. Increased expression of COX-2 was determined in tumors with metastases to regional lymph nodes (53.66 66 [38.46-68.52] % - 63.64 (34.52-88.13] %), large size (73, 81 (59.63-85.82] % - 85.71 [52.74-99.97] %), running clinical stage (65.12 [54.78-74.78] %), with a low degree of differentiation G3 (80.95 [61.88-94.45] %), negative ER status and overexpression of HER-2/neu. Overexpression of COX-2 prevailed in patients under the age of 50 years (69.23 [54.04-82.54] %), in patients with triple-negative carcinoma phenotype (75.00 [54.26-91.01] %) and HER-2/neu + phenotype of invasive ductal breast cancer (73.68 [52.19-90.47] %). Conclusion. Overexpression of COX-2 has been associated with adverse prognosis factors such as young age, metastatic lymph node involvement, large tumor size, G3 poorly differentiation (high grade), negative ER status and HER-2/neu overexpression, and has been associated with an increased risk of recurrence of the disease, progression of the tumor process, increased risk of death. Overexpression of COX-2 may be a sign of an aggressive phenotype with metastatic potential, depend on hormonal status and be useful as a prognostic biomarker of invasive ductal breast cancer

Keywords: invasive ductal breast cancer, COX-2 expression, prognostic factors

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