Nuclear pleomorphism, a strong prognostic factor in axillary node-negative small invasive breast cancer.
We have evaluated established risk factors (tumor size, menopausal status, receptor status, tumor histology, and grading according to Bloom & Richardson including subfactor analysis) as well as local therapeutic procedures in a series of 121 patients with axillary node-negative (ANN) breast cancer stage T1a and T1b. The patients were operated on at a single institution (Department of Surgery, Hanuschkrankenhaus, Vienna) from 1969 to 1989. After a median observation time of 185 months, a total of 16 patients (13%) had a recurrence; of these, 6 had died of the primary disease by the control date (Dec 1, 1990). Grading (distant recurrence-free survival (DRFS) p = 0.01, overall survival (OS) p = 0.006, mitosis rate (DRFS p = 0.006, OS p = 0.02), and particularly nuclear pleomorphism (DRFS p = 0.0002, OS p = 0.00001) proved to have prognostic impact on distant recurrence-free survival and/or overall survival (Mantel-Cox log rank test; level of significance: p = 0.006 after adjustment for multiple testing by Bonferroni correction). Therapeutic procedures had a borderline-significant impact on local recurrence (p = 0.09). No other parameters had statistically significant impact. Thus, our long-term analysis confirms the superior prognostic relevance of histologic grading and nuclear pleomorphism in patients with ANN breast cancer stage T1a and T1b.
Stierer
M
M
Department of Surgery, Hanuschkrankenhaus, Vienna, Austria.
Rosen
H
H
Weber
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D002467:Cell Nucleus / Q000648:ultrastructure*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D008938:Mitosis; D011379:Prognosis; D011960:Receptors, Estrogen; D012307:Risk Factors; D015996:Survival Rate
D011960:Receptors, Estrogen