Immunohistochemical Expression of CD47 in Breast Cancer in Iraqi Female Patients

Background: Breast cancer (BC) remains the most prevalent malignancy and a leading cause of cancer-related death among women globally. In Iraq, it is the most commonly diagnosed female cancer. Cluster of Differentiation 47 (CD47), a membrane glycoprotein found on most cells, binds to Signal Regulatory Protein alpha (SIRP alpha) on macrophages to transmit a "don't eat me" signal, inhibiting phagocytosis. Methods: A total of 100 breast tissue samples were collected from various Iraqi hospitals and laboratories. This retrospective case-control study included 70 malignant and 30 control samples obtained from the Forensic Medicine Institute in Baghdad with official approvals. IHC analysis was done to assess CD47 expression. Chi-square test and Fisher’s exact test were used with Bonferroni correction for multiple comparisons. Results: CD47 expression showed a statistically significant difference between the malignant tumor group and the non-malignant group. CD47 high expression was observed in malignant cases (61/70, 87.1%) compared to controls (0/30, 0%). No statistically significant association was observed between CD47 expression and pathological stage after Bonferroni correction (p = 0.075). Conclusion: CD47 expression was associated with malignancy. However, no significant associations between CD47 expression and clinicopathological parameters were confirmed, suggesting that the finding represents an association rather than having a diagnostic or prognostic value. These findings support conducting further research on CD47 to validate these observations and clarify its expression pattern in breast cancer.