The Relative Significance of Prognostic Factors in Breast Carcinoma

Alderson, Michael; Hamlin, Iris M. E.; Staunton, Marie

doi:10.1038/bjc.1971.80

Cited by 94 publications

(34 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This may also help to explain some of the apparently contradictory findings in the literature. Reports published since 1970 that have shown no significant relationship between delay and survival have generally been confined to patients with early stage (operable) disease (Alderson et al, 1971;Dennis et al, 1975;Wallgren et al, 1976;Fisher et al, 1977).…”

Section: Discussionmentioning

confidence: 99%

The influence on survival of delay in the presentation and treatment of symptomatic breast cancer

et al. 1999

View full text Add to dashboard Cite

SummaryThe aim of this study was to examine the possible influence on survival of delays prior to presentation and/or treatment among women with breast cancer. Duration of symptoms prior to hospital referral was recorded for 2964 women who presented with any stage of breast cancer to Guy's Hospital between 1975 and. Median follow-up is 12.5 years. The impact of delay (defined as having symptoms for 12 or more weeks) on survival was measured from the date of diagnosis and from the date when the patient first noticed symptoms to control for lead-time bias. Thirty-two per cent (942/2964) of patients had symptoms for 12 or more weeks before their first hospital visit and 32% (302/942) of patients with delays of 12 or more weeks had locally advanced or metastatic disease, compared with only 10% (210/2022) of those with delays of less than 12 weeks (P < 0.0001). Survival measured both from the date of diagnosis (P < 0.001) and from the onset of the patient's symptoms (P = 0.003) was worse among women with longer delays. Ten years after the onset of symptoms, survival was 52% for women with delays less than 12 weeks and 47% for those with longer delays. At 20 years the survival rates were 34% and 24% respectively. Furthermore, patients with delays of 12-26 weeks had significantly worse survival rates than those with delays of less than 12 weeks. Multivariate analyses indicated that the adverse impact of delay in presentation on survival was attributable to an association between longer delays and more advanced stage. However, within individual stages, longer delay had no adverse impact on survival. Analyses based on 'total delay' (i.e. the interval between a patient first noticing symptoms and starting treatment) yielded very similar results in terms of survival to those based on delay to first hospital visit (delay in presentation).

show abstract

Section: Discussionmentioning

confidence: 99%

The influence on survival of delay in the presentation and treatment of symptomatic breast cancer

et al. 1999

View full text Add to dashboard Cite

show abstract

“…The significance of lymphoplasmacytic reaction has been debated for many years (Cutler et al, 1969;Alderson et al, 1971;Rosen et al, 1981a;Dawson et al, 1982). Although considered by many to be an expression of host defence reaction and, therefore, indicative of a favourable prognosis, this has not been confirmed by others.…”

Section: Discussionmentioning

confidence: 99%

Histopathology of breast cancer in relation to age

Fisher

Egan²,

Smith³

et al. 1997

Br J Cancer

149

View full text Add to dashboard Cite

Summary Histological reports of 1869 consecutive women with invasive breast cancer have been reviewed to determine whether histological features of the tumours were related to the patients' age. The patients, treated between 1983 and 1992, were divided into four groups, based on age. There were 148 aged < 39 years, 355 aged [40][41][42][43][44][45][46][47][48][49] years, 984 aged 50-69 years and 382 aged 70 years or more. The most outstanding finding was the increase in incidence of grade IlIl infiltrating ductal carcinoma in those aged < 39 years (P< 0.0001). Certain tumour types, in particular lobular, were reported more frequently in the oldest age group. Additionally, there was a significant reduction of axillary lymph node metastases, vascular invasion and lymphoplasmacytic stromal reaction with increasing age, all of which were independent of tumour grade. These data suggest that there may be age-related changes in the histology of breast cancer and, in some cases, less aggressive features in the elderly. However, as the life expectancy of women over the age of 70 may be many years, treatment should be based on histological prognostic features of the primary tumour rather than age alone.Keywords: breast cancer; histology; age; tumour grade; axillary nodes There are reports indicating that breast cancer has a relatively unfavourable prognosis in young women (Jacquemier et al, 1985;Rosen et al, 1985;Rochefordiere et al, 1993), but is a disease of good prognosis among the elderly (Rosen et al, 1985). However, others have suggested that age does not influence the behaviour of the disease (Schaefer et al, 1984). Relatively few comparative studies of histological features of breast cancer in the young and old have been conducted. It has been reported that there is a significantly lower mean age for patients with medullary carcinoma, while lobular and mucoid carcinomas are relatively more frequent in the elderly (Rosen et al, 1985). Intracystic papillary carcinoma is also found more frequently in older women (Carter et al, 1983). In addition, it has been suggested that younger women have more aggressive high-grade tumours than the elderly (Jacquemier et al, 1985;Rosen et al, 1985).The aim of the present investigation was to review a large series of patients with invasive breast cancer and to analyse a variety of histopathological findings in relation to age, in order to determine whether there were any indications of less or more aggressive features in different age groups. PATIENTS AND METHODSThe study comprised 1869 women with invasive breast cancer who were treated consecutively at the Breast Unit, Guy's Hospital, in the 10-year period 1983-1992. The patients were divided into four age groups, < 39 years, 40-49 years, 50-69 years and > 70 years. These age groups were selected for the following reasons.The cut-off age for young women has ranged from 30-45 years in previous studies (Jacquemier et al, 1985;Rosen et al, 1985;Lee et al, 1992 Correspondence to: IS Fentiman reasonable size, which was compatible with ...

show abstract

“…Another approach to the investigation of the relationship of fibrocystic disease to cancer has been to determine the incidence of the former in biopsies of patients whose breasts have been subsequently removed for carcinoma. Results 2.5% of 1200 patients with breast cancer had a previous biopsy revealing benign disease, whereas only 1.1 % of 120 patients with cancer elsewhere had a previous breast biopsy which revealed benign disease. Black and associatesz2 reviewed the breast biopsies obtained years previously from 93 patients with cancer, and found that an appreciable number had in situ cancer or "precancerous mastopathy," although the original diagnosis rendered was only that of fibrocystic disease.…”

mentioning

confidence: 97%

The pathology of invasive breast cancerA Syllabus Derived from Findings of the National Surgical Adjuvant Breast Project (Protocol No. 4)

Fisher

Gregorio²,

Fisher³

et al. 1975

Cancer

716

140

View full text Add to dashboard Cite

The inter-relationships of 32 pathologic and 7 clinical parameters encountered in the study of 1000 examples of invasive breast carcinoma have been presented. In some instances the biological significance of these associations is at present unclear. In others it is to be noted that there is no information provided as to the rank of their significance. Nevertheless, the associations that were encountered not only help further characterize the various forms of breast cancer but also provide information regarding the possible biological significance of some of their features. Although it is not our intention to minimize the possible significance of the inter-relationships of pathologic parameters, most emphasis in the summarizing statements which follow has been placed upon those correlations which may relate to prognosis. In this regard reference has been made to short-term treatment failure, vis a vis local recurrence and/or metastases, which may not necessarily accurately reflect patient survival, although generally such a relationship exists. Information in this regard as well as to the rank of the significance of these pathologic features shall be forthcoming when sufficient time has elapsed since the inception of this study to allow for such conclusions, i.e. survival or long-term treatment failure rates. Lastly, it becomes evident that the guidelines followed in the examination of these specimens appear to represent at least the minimum requirements necessary for a meaningful pathologic evaluation of breast carcinoma.

show abstract

The Relative Significance of Prognostic Factors in Breast Carcinoma

Cited by 94 publications

References 6 publications

The influence on survival of delay in the presentation and treatment of symptomatic breast cancer

The influence on survival of delay in the presentation and treatment of symptomatic breast cancer

Histopathology of breast cancer in relation to age

The pathology of invasive breast cancerA Syllabus Derived from Findings of the National Surgical Adjuvant Breast Project (Protocol No. 4)

Contact Info

Product

Resources

About