Two techniques for measuring invasion in solid tumors. Evaluated in a retrospective study of 73 cases of breast carcinoma with 10-year follow-up.
Two methods are described which measure invasion in solid tumors: 1) average tumor extension, i.e. the distance between the edge of the primary tumor mass and the furthest extension of tumor nests in the adjacent stroma, and 2) total surface of tumor exposed to stroma, obtained by multiplying the volume within 1 mm of the outer margin of the primary tumor by the stereologically derived ratio of tumor surface to its volume. These techniques are applied to a retrospective review of 73 consecutive cases of female breast cancer with known lymph node status and without distant metastases at the time of the original diagnosis. The study explores how these parameters discriminate 10-year survivors from non-survivors and compares them with other known significant parameters of tumor aggressiveness, i.e. axillary lymph node status, mitotic count, tumor diameter, tumor/desmoplasia ratio, necrosis/tumor ratio, gland space/tumor ratio, nuclear volume (= nuclear grade), and age at diagnosis. This study concludes: 1) Each parameter of invasion, adjusted in the analysis for lymph node status and mitotic count, emerges as statistically significant with low invasion in the primary tumor conferring a better prognosis than high invasion. 2) The associations low mitoses/low invasion, high mitoses/low invasion and low mitoses/high invasion tend to indicate a favorable 10-year survival, while the combination high mitoses/high invasion results in poor survival. 3) There was a greater percentage of high invasion cases in the LN > 0 subgroup compared to the LN 0 subgroup, suggesting that high invasion in the primary tumor predisposes to metastases, but this trend did not always reach statistical significance. 4) The proposed methodology offers a practical approach for measuring invasion in solid tumors.
Laroye
G J
GJ
Department of Oncologic Pathology, Ontario Cancer Institute, Toronto, Canada.
Panzarella
T
T
D000367:Age Factors; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006652:Histological Techniques; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D008938:Mitosis; D009336:Necrosis; D009361:Neoplasm Invasiveness / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors