title: Biologic and clinicopathologic factors as indicators of specific relapse types in node-negative breast cancer.
abstract: OBJECTIVE
  We evaluated, in 1,800 patients with node-negative tumors treated with locoregional therapy until relapse, the competitive risks for different types of metastasis by cell proliferation (3H-thymidine labeling index [3H-dT LI]), estrogen receptors (ERs), and progesterone receptors (PgRs), and by the integration of biologic and clinicopathologic information.
  
  
  RESULTS
  Hormone receptor status and proliferative activity of the primary tumor were not indicative of contralateral failures. Hormone receptors failed to predict the 8-year incidence of locoregional recurrence, but they were significant indicators of distant metastasis and overall survival. The latter finding was confirmed even in multivariate analysis. Conversely, cell proliferation predicted both locoregional and distant metastases and survival, regardless of patient age, tumor size, and ER and PgR status. Recursive partitioning and amalgamation analysis ascribed to cell proliferation an important prognostic role for locoregional recurrence together with patient age and tumor size.
  
  
  CONCLUSIONS
  Biologic markers, in particular cell proliferation, provide information for the different types of relapse and could complement the predictive role of pathologic staging.
authors.affiliation: Oncologia Sperimentale C, Instituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Silvestrini
authors.forename: M G
authors.initials: MG
authors.lastname: Daidone
authors.forename: A
authors.initials: A
authors.lastname: Luisi
authors.forename: P
authors.initials: P
authors.lastname: Boracchi
authors.forename: M
authors.initials: M
authors.lastname: Mezzetti
authors.forename: G
authors.initials: G
authors.lastname: Di Fronzo
authors.forename: S
authors.initials: S
authors.lastname: Andreola
authors.forename: B
authors.initials: B
authors.lastname: Salvadori
authors.forename: U
authors.initials: U
authors.lastname: Veronesi
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D002455:Cell Division; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012044:Regression Analysis; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone