High tumour grade and larger size were shown to independently predict earlier breast cancer relapse. While LN involvement increases absolute recurrence risk, our study proposes that it does not influence timing of relapse. Use of these predictors will enable key risk periods for onset of relapse to be characterised according to tumour profile with more appropriate discharge to primary care providers for ongoing surveillance.

A prospective study has been carried out in 172 women to determine the sensitivity of methods to detect occult metastatic disease in the skeleton and liver. With the exception of bone scintiscans, the results of these tests bore little relationship to recurrence rates. On the other hand, knowledge of the histopathology of the lower axillary (pectoral) lymph nodes is of value in this respect.A follow-up study is also reported which confirms the importance of accurate measurements of the primary tumour clinical node status and oestrogen receptor contact of the tumour in defining prognostic groups. Elastosis (estimated in 165 tumours) did not prove to be a useful prognostic index.

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Human breast secretions as collected by nipple aspiration have been analysed for dehydroepiandrosterone sulphate by radioimmunoassay. All secretions collected from non-lactating normal women contained remarkably high levels of dehydroepiandrosterone sulphate as compared with plasma taken at the same time. Although there was a large range of concentrations, levels were of a similar magnitude in different ducts from the same breast and in different breasts from the same individual. No significant difference was detected between secretions from pre and postmenopausal women. Sequential sampling of breast secretions through the menstrual cycle in two normal premenopausal women showed no cyclic variation in dehydroepiandrosterone sulphate concentration. There was also no significant difference between levels in breast secretions obtained from normal women and patients with either malignant or benign breast disease. Analysis of secretions from tumour and non-tumour bearing breasts in cancer patients failed to show consistent differences although, in contrast to normal women, the variation between breasts in individual patients was often marked.