Prognostic Factors after 5 Years Follow-Up in Female Breast Cancer

Abstract

A consecutive series of breast carcinomas (n = 595) followed up for a minimum of 7.5 years was analyzed for clinical, histological and morphometric prognostic factors after 5-years’ follow-up. Tumor size, nodal status, mitotic frequency and patients1 age at diagnosis predicted survival at 7.5 years highly significantly (p < 0.0001). Tubule formation (p = 0.002), histological grade (p = 0.026) and nuclear pleomorphism (p = 0.046) were related to prognosis as well. In Inpatients mitotic frequency (p = 0.018) was the best predictor of survival at 7.5 years whereas in N+ tumors tumor size (p = 0.0013), tubule formation (p = 0.003) and mitotic frequency (p = 0.0049) were the best predictors of survival at 7.5 years. In univariate survival analysis the age of the patients (p = 0.002), tubule formation (p = 0.005), axillary lymph node status (p = 0.008), lymphocyte infiltration (p = 0.049), mitotic frequency (p = 0.06) and tumor size (p = 0.08) predicted survival after 5 years’ follow-up. Tubule formation predicted survival (p = 0.025) in N – patients and in N + tumors the age of the patients was the most important predictor (p = 0.006). In Cox’s analysis tubule formation (p = 0.13), axillary lymph node status (p = 0.033), SD of nuclear perimetry (p = 0.046) and intraductal growth (p = 0.059) predicted survival independently after 5 years’ follow-up.

Correlation of growth fraction by Ki-67 and proliferating cell nuclear antigen (PCNA) immunohistochemistry with histopathological parameters and prognosis in primary breast carcinomas

“…It was thus demonstrated that Ki-67 and PCNA had the same prognostic significance in lymph node-positive and -negative patients. This finding is also in accordance with most other studies [17,36,38,42,43], although Gasparini et al [44] found that PCNA overexpression was not a parameter of poor overall survival. In that study the follow-up period was 5 years.…”

“…The correlation between the staining results of Ki-67 and PCNA and clinicopathological parameters are in accordance with most other studies [17,20,[35][36][37][38][39][40]42]. Both Ki-67 and PCNA were found to be correlated with a high number of mitoses, which indicates they are markers of proliferation.…”

Lymph Node-Negative Breast Cancer: The Prognostic Role and Time Dependency of Age, Tumor Diameter and Mean Nuclear Area

“…In our opinion morpho metric features, such as MNA, are comparable to grading as a prognostic factor, and should be preferred due to its higher reproducibility and more objective nature [7], While MNA was the strongest variable during the first 5-year follow-up, only tumor diameter maintained prog nostic strength throughout the 10-year observation peri od. This is in agreement with the work of Toikkanen et al [30,40] showing tumor size to predict both early and late mortality significantly, but in disagreement with Aaltomaa et al [41 ], who found that tumor diameter was not of significance in lymph node-negative patients when esti mating 7.5-year survival for those who had survived 5 years. Our data on tumor size are, however, comparable to those from the Surveillance Epidemiology and End Results Program of the National Cancer Institute, Bethesda, showing more than 90% survival in 5,728 node-nega tive patients with a tumor size under 2.0 cm [3], Our results are also in agreement with McGuire et al [ 15] that tumor size is relevant in deciding on adjuvant therapy in lymph node-negative patients.…”

'Missed' Micrometastases: The Extent of the Problem

“…While the number of tumour bearing lymph nodes is an important prognostic factor in these patients (2)(3)(4)(5), the value of detecting small tumour deposits (micrometastasis) is much debated (6)(7)(8)(9). Some authors (6) have found that such metastases are not worth detecting, mainly because of their low prognostic impact and the high cost of detection.…”