FoxA1 (forkhead box protein A1) is one of three members in the FoxA related family (forkhead 
family of transcriptions factors). FoxA related family proteins are often termed “pioneer factors" 
because of their ability to bind to highly compacted heterochromatin and making genomic regions 
more accessible to other transcription factors. This study aimed to evaluate the clinical significance of 
FoxA1 expression in invasive duct carcinoma of the breast and in corresponding lymph node 
metastasis. FoxA1 expression was examined in 70 tumor tissues plus 53 paraffin blocks of 
corresponding lymph node metastasis by immunohistochemistry. The association between expression
of this marker and clinicopathologic parameters was analyzed. Also comparison between FoxA1 
expression in the primary tumor and corresponding lymph node metastasis was done in 53 pairs. 
FoxA1 was positive in (45.7%) of cases. FoxA1 expression was associated with tumor grade
(p= 0.046), lymph node status (>3 lymph nodes) (p = 0.049), tumor stage (p=0.009), prognostic stage 
(p=0.001), good Nottingham prognostic index (p=0.042), ER and PR positivity (p=0.028 and 0.033
respectively), Her2 negativity (p= 0.019), Molecular subtypes (p=0.038) and distant metastasis 
(p=0.004). As regard FoxA1 expression in primary tumor and corresponding lymph node metastasis, 96.2% 
of pairs revealed a concordance between the primary tumor and corresponding lymph node metastasis and 
only 2 cases (3.8%) were nonconcordant but the results weren't statistically significant. These 
findings suggest that FoxA1 expression can be considered as a good prognostic and therapeutic 
marker for targeted therapy of breast cancer patients.