BackgroundBreast cancer is a heterogenous disease that impacts racial/ethnic groups differently. Differences in genetic composition, lifestyles, reproductive factors, or environmental exposures may contribute to the differential presentation of breast cancer among Hispanic women.Materials and MethodsA population-based study was conducted in the city of Santiago de Compostela, Spain. A total of 645 women diagnosed with operable invasive breast cancer between 1992 and 2005 participated in the study. Data on demographics, breast cancer risk factors, and clinico-pathological characteristics of the tumors were collected. Hormone receptor negative tumors were compared with hormone receptor postive tumors on their clinico-pathological characteristics as well as risk factor profiles.ResultsAmong the 645 breast cancer patients, 78% were estrogen receptor-positive (ER+) or progesterone receptor-positive (PR+), and 22% were ER−&PR−. Women with a family history of breast cancer were more likely to have ER−&PR− tumors than women without a family history (Odds ratio, 1.43; 95% confidence interval, 0.91–2.26). This association was limited to cancers diagnosed before age 50 (Odds ratio, 2.79; 95% confidence interval, 1.34–5.81).ConclusionsAn increased proportion of ER−&PR− breast cancer was observed among younger Spanish women with a family history of the disease.
The clinicopathological features currently used in breast cancer prognosis often fail to characterize the clinical heterogeneity of the disease accurately. Our study is aimed to investigate the predictive value of DNA flow cytometry in breast cancer. Previously untreated breast carcinoma samples (584) were snap frozen for flow-cytometry. Tumors were classified into three DNA index (DI) categories: i) tumors showing a DI =0.96-1.15 (diploid and near-diploid); ii) tumors with a DI ≥1.16 (hyperdiploid, tetraploid, multiploid and/or those with more than one diploid population); and iii) tumors with a DI ≤0.95 (hypoploid). The 5-and 10-year cumulative survival rates ± SE for Group I (n=191) were 98±1% and 98±1%. For Group II (n=361) these rates were 77±2% at 5 years and 63±5% at 10 years. In Group III (n=32) the rate at 5 years was 23±8%, with no patients alive at 10 years (p<0.0001). In univariate analysis, tumor size, node status, grade, karyometry, S-phase fraction, MIB-1 index, and estrogen receptors retained prognostic significance; in multivariate analysis, only DI ≤0.95 (hypoploid) was retained as an independent prognostic factor for overall survival. Our data strongly support that DNA hypoploid has a strong, independent prognostic value for predicting the short-term clinical outcome of breast carcinoma patients.
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