The value of routine biochemical and surgical pathology quantities in predicting recurrence in high-risk patients following surgery for primary breast cancer.
The initial biochemical data (serum[S]-carcinoembryonic antigen, S-lactate dehydrogenase, S-gammaglutamyl transferase, S-alkaline phosphatase urine[U]-creatinine, and three urinary quantities related to collagen metabolism) and surgical pathology data (tumor size, grade of tumor anaplasia, number of positive lymph nodes, number of negative lymph nodes) were examined in 52 consecutive postmenopausal risk group II patients operated for primary breast cancer without metastatic disease (mastectomy + partial axillary resection) who participated in the Danish Breast Cancer Group's controlled clinical trial of radiation (RT) alone, and RT + levamisol. The follow-up (mean = 3.45 years, range = 3-4 years) included physical examination every three months, x-ray of chest, bone scan, and x-ray of axial skeleton every six months. Recurrence was defined as metastatic disease detected during the first three years of postoperative follow-up study. Twenty patients had recurrences. A stepwise discriminant analysis of the surgical pathology quantities showed that all quantities except tumor size contributed significantly (P less than 0.01) to the discrimination between controls (no recurrence after 3-4 years) and patients who had recurrences within three years. When each of the biochemical quantities was combined with the surgical pathology data it was found that only urinary total hydroxy-proline to creatinine ratio improved the discrimination significantly (P less than 0.05) and that the effect was marginal.
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002986:Clinical Trials as Topic; D003094:Collagen / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D012008:Recurrence; D012306:Risk; D005723:gamma-Glutamyltransferase / Q000097:blood
D002272:Carcinoembryonic Antigen; D003094:Collagen; D007770:L-Lactate Dehydrogenase; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase