title: DNA ploidy, S-phase fraction and mitotic indices as prognostic predictors of female breast cancer.
abstract: DNA ploidy, S-phase fraction (SPF), mitotic index (MI), volume corrected mitotic index (M/V index) and standard prognostic factors were related to disease outcome in a series of 363 women with breast cancer followed-up for over 10 years in our clinic. DNA ploidy and SPF were significantly related to histological type, tumour grade and mitotic indices (p < 0.001). In univariate survival analysis, pN status (p < 0.0001), tumour diameter (p < 0.0001), MI (p = 0.001), M/V index (p = 0.0003) and SPF (p = 0.015) predicted survival. In pN(-) tumours. MI (p = 0.059) was related to survival. In pN(+) tumours, tumour diameter (p = 0.0004), M/V index (p = 0.023) and SPF (p = 0.045) predicted survival. In multivariate survival analysis, tumour diameter (p < 0.001). M/V index (p < 0.007), pN status (p = 0.014) and patient age (p = 0.09) were independently related to survival. In pN(-) tumours, tumour diameter independently predicted survival (p = 0.033). In pN(+) tumours, tumour diameter (p < 0.001), M/V index (p = 0.006) and the year of treatment (p = 0.08) were independent predictors. The results show that tumour diameter, pN status and proliferative activity of cancer cells are important prognostic factors in breast cancer. Of the proliferation indices, M/V index and SPF are equally powerful predictors, and the use of M/V index is advocated due to simplicity of the assessment.
authors.affiliation: Department of Pathology, University of Kuopio, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Lipponen
authors.forename: S
authors.initials: S
authors.lastname: Papinaho
authors.forename: M
authors.initials: M
authors.lastname: Eskelinen
authors.forename: P J
authors.initials: PJ
authors.lastname: Klemi
authors.forename: S
authors.initials: S
authors.lastname: Aaltomaa
authors.forename: V M
authors.initials: VM
authors.lastname: Kosma
authors.forename: S
authors.initials: S
authors.lastname: Marin
authors.forename: K
authors.initials: K
authors.lastname: Syrjänen
mesh_terms: D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D004273:DNA, Neoplasm / Q000032:analysis* / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D008940:Mitotic Index; D009361:Neoplasm Invasiveness; D011003:Ploidies; D011379:Prognosis; D016196:S Phase; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D004273:DNA, Neoplasm