title: Mammographic growth rate, DNA ploidy, and S-phase fraction analysis in breast carcinoma. A prognostic evaluation in a screened population.
abstract: BACKGROUND
  The authors examined prognostic factors in 158 cases of breast carcinoma with known mammographic tumor volume doubling times (DT).
  
  
  METHODS
  The tumors were retrospectively reexamined histologically and flow cytometric analysis of DNA ploidy and S-phase fraction (SPF) was performed on archival paraffin-embedded material in each case. Life tables and Cox multivariate analyses were used for statistical evaluation of prognostic factors.
  
  
  RESULTS
  In univariate analysis of survival data, clinical and pathologic stage, histologic grade, the presence of axillary lymph node metastases, and SPF were significant prognostic predictors, but mammographic DT and DNA ploidy were not. SPF also contributed prognostic information in the subgroup of carcinoma cases detected by screening. In a Cox multivariate analysis, SPF, the presence of axillary lymph node metastases, and Stage II-III disease (as opposed to Stage I disease) were independent significant predictors of survival. In univariate analyses of distant disease-free survival, clinical and pathologic stage, tumor size, histologic grade, the presence of involved axillary nodes, DT, and SPF all were significant prognostic factors.
  
  
  CONCLUSIONS
  SPF, stage, and lymph node status were important prognostic factors in this patient material with predominantly small and node-negative breast carcinomas, whereas DNA ploidy and mammographic DT provided less prognostic information. The prognosis of carcinoma detected during screening did not differ significantly from that of breast carcinoma discovered otherwise in this selected patient group.
authors.affiliation: Department of Surgery, University Hospital, University of Umeå, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Arnerlöv
authors.forename: S O
authors.initials: SO
authors.lastname: Emdin
authors.forename: B
authors.initials: B
authors.lastname: Lundgren
authors.forename: G
authors.initials: G
authors.lastname: Roos
authors.forename: J
authors.initials: J
authors.lastname: Söderström
authors.forename: L
authors.initials: L
authors.lastname: Bjersing
authors.forename: C
authors.initials: C
authors.lastname: Norberg
authors.forename: K A
authors.initials: KA
authors.lastname: Angquist
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000517:prevention & control / Q000628:therapy; D002277:Carcinoma / Q000235:genetics* / Q000473:pathology* / Q000628:therapy; D002455:Cell Division; D004273:DNA, Neoplasm / Q000032:analysis; D005434:Flow Cytometry; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D011003:Ploidies; D011379:Prognosis; D016196:S Phase; D016019:Survival Analysis
chemical_list: D004273:DNA, Neoplasm