Evaluation of the prognostic value of triple node biopsy in early breast cancer

Toit, R.S. Du; Locker, A. P.; Elis, I. O.; Elston, C.W.; Blarney, R.W.

doi:10.1002/bjs.1800770216

Cited by 31 publications

(18 citation statements)

References 15 publications

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“…The stratification of lymph node stage for patients who underwent triple node biopsy depends on the level of axillary node involvement and/or involvement of the internal mammary chain and has been previously reported by our unit (Du Toit et al, 1990). Using our current staging system, node-negative disease is stage A, involvement of 1-3 axillary nodes or involvement of the internal mammary node chain is stage B and involvement of four or more axillary nodes or involvement of both axillary and internal mammary nodes is stage C. Histological tumour grade was determined using the method described by Elston and Ellis (1991).…”

Section: Histopathologymentioning

confidence: 70%

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Early-onset breast cancer – histopathological and prognostic considerations

Kollias

Elston²,

Ellis³

et al. 1997

Br J Cancer

189

111

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Summary Young age at diagnosis is claimed to be a prognostic factor in the natural history of breast cancer. Of 2879 patients aged < 70 years treated for primary operable breast cancer (< 5 cm diameter) at Nottingham City Hospital between 1973 and 1993, 120 were less than 35 years of age at diagnosis. Histopathological and prognostic variables were compared between patients aged < 35, 35-50 and 51-70 years. A significant reduction in metastasis disease-free survival and actuarial survival was seen in breast cancer patients aged < 35 years compared with the two older age groups. Patients aged < 35 years at diagnosis presented more frequently with high-grade cancers and vascular invasion. No differences were seen for tumour size or lymph node stage. The Nottingham Prognostic Index (NPI) was used to stratify cancers in each age group. Because of the tendency to high grade, a greater percentage of patients aged < 35 years fell into the poorprognosis group. Within each prognostic group, no difference in actuarial survival was seen between age groups. The association of young age at diagnosis with a worse prognosis in this series is explained by a higher proportion of poorly differentiated cancers; age itself had no influence on the prognosis of the individual.

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Section: Histopathologymentioning

confidence: 70%

“…A triple node sampling procedure was performed until February 1988(Du Toit et al, 1990. Nodes were sampled from the lower axilla, the apex of the axilla and the internal mammary chain.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Early-onset breast cancer – histopathological and prognostic considerations

Kollias

Elston²,

Ellis³

et al. 1997

Br J Cancer

189

111

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“…Stage A, stage B and stage C denoted lesions with 0, with ≤ 3 and with > 3 involved lymph nodes, respectively [28]. Thus, on the basis of obtained NPI, each patient was assigned to one of three prognostic groups: Good (NPI ≤ 3.4), Moderate (3.4 < NPI ≤ 5.4) and Poor (NPI > 5.4).…”

Section: Methodsmentioning

confidence: 99%

Peritumoral vascular invasion and NHERF1 expression define an immunophenotype of grade 2 invasive breast cancer associated with poor prognosis

Malfettone¹,

Saponaro²,

Paradiso³

et al. 2012

BMC Cancer

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BackgroundTraditional determinants proven to be of prognostic importance in breast cancer include the TNM staging, histological grade, proliferative activity, hormone receptor status and HER2 overexpression. One of the limitations of the histological grading scheme is that a high percentage of breast cancers are still classified as grade 2, a category with ambiguous clinical significance. The aim of this study was to best characterize tumors scored as grade 2.MethodsWe investigated traditional prognostic factors and a panel of tumor markers not used in routine diagnosis, such as NHERF1, VEGFR1, HIF-1α and TWIST1, in 187 primary invasive breast cancers by immunohistochemistry, stratifying patients into good and poor prognostic groups by the Nottingham Prognostic Index.ResultsGrade 2 subgroup analysis showed that the PVI (p = 0.023) and the loss of membranous NHERF1 (p = 0.028) were adverse prognostic factors. Relevantly, 72% of grade 2 tumors were associated to PVI+/membranous NHERF1- expression phenotype, characterizing an adverse prognosis (p = 0.000). Multivariate logistic regression analysis in the whole series revealed poor prognosis correlated with PVI and MIB1 (p = 0.000 and p = 0.001, respectively). Furthermore, in the whole series of breast cancers we found cytoplasmic NHERF1 expression positively correlated to VEGFR1 (r = 0.382, p = 0.000), and in VEGFR1-overexpressing tumors the oncogenic receptor co-localized with NHERF1 at cytoplasmic level.ConclusionsThe PVI+/membranous NHERF1- expression phenotype identifies a category of grade 2 tumors with the worst prognosis, including patient subgroup with a family history of breast cancer. These observations support the idea of the PVI+/membranous NHERF1- expression immunophenotype as a useful marker, which could improve the accuracy of predicting clinical outcome in grade 2 tumors.

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“…Analysis of this data by du Toit [21] showed that only 6% of patients would have been understaged by the omission of internal mammary node sampling, although this procedure appears useful in medial tumours. This analysis also showed that when both chains of nodes were involved the prognosis was equivalent to that of high (apical) node involvement.…”

Section: Lymph Node Involvementmentioning

confidence: 96%

The Nottingham prognostic index in primary breast cancer

Galea

Blamey

et al. 1992

Breast Cancer Res Tr

912

615

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In 1982 we constructed a prognostic index for patients with primary, operable breast cancer. This index was based on a retrospective analysis of 9 factors in 387 patients. Only 3 of the factors (tumour size, stage of disease, and tumour grade) remained significant on multivariate analysis. The index was subsequently validated in a prospective study of 320 patients. We now present the results of applying this prognostic index to all of the first 1,629 patients in our series of operable breast cancer up to the age of 70. We have used the index to define three subsets of patients with different chances of dying from breast cancer: 1) good prognosis, comprising 29% of patients with 80% 15-year survival; 2) moderate prognosis, 54% of patients with 42% 15-year survival; 3) poor prognosis, 17% of patients with 13% 15-year survival. The 15-year survival of an age-matched female population was 83%.

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Evaluation of the prognostic value of triple node biopsy in early breast cancer

Cited by 31 publications

References 15 publications

Early-onset breast cancer – histopathological and prognostic considerations

Early-onset breast cancer – histopathological and prognostic considerations

Peritumoral vascular invasion and NHERF1 expression define an immunophenotype of grade 2 invasive breast cancer associated with poor prognosis

The Nottingham prognostic index in primary breast cancer

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