Focal adhesion kinase (FAK) is a protein tyrosine kinase expressed in invasive breast cancer that regulates antiapoptotic signaling. We have examined FAK expression by immunohistochemistry using anti-FAK 4.47 in breast tumor samples from a large population-based, case-control study of women participating in the University of North Carolina Breast Specialized Programs of Research Excellence (SPORE), Carolina Breast Cancer Study. In this population, 629 formalin-fixed, paraffin-embedded tissue sections were stained for FAK and scored as high (3 þ or 4 þ intensity and Z90% positive cells) or otherwise. High FAK expression was associated with poor prognostic indicators including high mitotic index (410 mitoses per 10 consecutive highpower fields), nuclear grade 3, architectural grade 3, estrogen and progesterone receptor negative, and HER-2/ neu overexpressed using CB11 antibody. The association of high FAK expression with HER-2/neu overexpression lends further support that HER-2/neu and FAK collaborate to promote tumorigenesis. The presence of strong FAK expression in many high grade, estrogen-and progesterone-negative breast carcinomas indicates that FAK may be an attractive target for therapeutic intervention.