Predictors of Recurrence and Survival of Patients with Breast Cancer

Abstract

In this study, the characteristics of 646 patient's primary breast carcinomas, including histologic grade (HG), nuclear grade (NG), mitotic grade (MG), final grade (FG), estrogen receptor (E2R) status, and patient's lymph node status (LN) at the time of surgery were correlated with recurrence-free interval and patient survival in order to determine whether any one parameter or group of parameters serve as adequate predictors of tumor behavior and, therefore, patient's prognosis. The authors' results showed that LN, tumor size, and tumor grade were themselves significant predictors of early recurrence and breast cancer death. Each unit increase in LN or MG increased the risk of death by a factor of 1.5 and 2.0, respectively. However, prediction of time to recurrence or death was considerably more accurate when those parameters were used in conjunction, rather than individually. E2R was also significant in predicting death. MG separated patients within a single LN group or E2R group into two subsets having clinically and statistically different prognoses. It was found that patients who had negative lymph nodes and whose tumors were MG1 had a better prognosis than those with MG2,3 tumors; in these latter patients recurrence and death patterns were similar to those of patients with MG1 tumors having one to three positive lymph nodes. Similarly, whereas patients with four or more positive lymph nodes had bad prognoses, those bearing MG1 tumors tended to behave more like those with MG2,3 tumors and having only one to three positive lymph nodes.

Lacking prognostic significance of β2-microglobulin, MHC class I and class II antigen expression in breast carcinomas

“…The reliability of our results is further strengthened by the identification of the axillary lymph node and hormone receptor status as independent prognostic factors for overall and disease-free survival. These parameters confirm the observations of the studies cited above as well as those from other investigations (Nemoto et al, 1980;Baak et al, 1985;Bryan et al, 1986;Fisher et al, 1987;Russo et al, 1987;Todd et al, 1987;Chevallier et al, 1988).…”

“…Sidky & Walker (1984) observed that histologically poorly differentiated carcinomas stained less for P2m- Zuk & Walker (1987) demonstrated a correlation between tumour grading and the expression of P2m and HLA-A,B,C. Regarding the prognostic value of tumour grading for breast cancer patients (Bloom & Richardson, 1957;Freedman et al, 1979;Haybittle et al, 1982;Reiner et al, 1985;Russo et al, 1987;Chevallier et al, 1988) (UICC, 1987; Table I). The identification of independent prognostic effects of MHC antigen expression was assessed by the Cox multivariate regression analysis.…”

Breast carcinoma malignancy grading by Bloom–Richardson system vs proliferation index: reproducibility of grade and advantages of proliferation index

“…Six studies were conducted on node-negative carcinomas, 26-31 13 on mixed node-negative/positive carcinomas, 8,16,[32][33][34][35][36][37][38][39][40][41][42] and two on node-positive carcinoma. 42,43 Architecture (tubularity) was the primary independent predictor in three, 27,29,43 nuclear pleomorphism by subjective assessment in two, 33,35 morphometric measurements of nuclear area in one, 36 and mitotic count in eight studies.…”

Clinico-Morphological Profile in Breast Cancer Patients in a Tertiary Care Hospital in Western Rajasthan

“…[7][8][9][10][11][12][13][14][15] However, only few studies from India are present. [16][17][18][19] and to the best of our knowledge, no study from Western Rajasthan regarding the clinico-histological parameters of breast cancer is available.…”