title: [Prognostic factors in breast carcinoma].
abstract: The prognostic factors in breast cancer are numerous and interdependent. The single most important variable is the total tumor cell burden as well as the marked heterogeneity of tumor cell population. In women with clinical localized disease, the progressive increase in the diameter of primary tumor is associated with higher incidence of histologically involved axillary nodes; in turn, this involvement, and particolarly its extent, represents an indirect sign of distant micrometastases. In women with clinical advanced disease, the extent of tumor cell burden (inflammatory carcinoma, multivisceral involvement) is associated with a decrease in the response rate by drug therapy. The percent of drug-resistant neoplastic cells is inversely related to the tumor mass; this resistant fraction represents today the limiting factor to a more effective contribution of medical treatment (i.e. long-term complete remission and cure) in all stages of breast cancer. The concept of breast cancer as systemic disease in a higher percent of women than thought in the past, allows to perform breast-saving procedures without affecting prognosis and stimulates treatment strategies utilizing a combined modality approach for high-risk women.
mesh_terms: D001365:Axilla; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000276:immunology / Q000473:pathology*; D002277:Carcinoma / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000032:analysis
chemical_list: D011956:Receptors, Cell Surface
vernacular_title: I fattori prognostici nel carcinoma mammario.