Prognostic, quantitative histopathologic variables in lobular carcinoma of the breast.
BACKGROUND
A retrospective investigation of 53 consecutively treated patients with operable lobular carcinoma of the breast, with a median follow-up of 6.6 years, was performed to examine the prognostic value of quantitative histopathologic parameters.


METHODS
The measurements were performed in routinely processed histologic sections using a simple, unbiased technique for the estimation of the three-dimensional mean nuclear volume (vv(nuc)). In addition, quantitative estimates were obtained of the mitotic index (MI), the nuclear index (NI), the nuclear volume fraction (Vv(nuc/tis)), and the mean nuclear profile area (aH(nuc)).


RESULTS
Estimates of vv(nuc), MI, NI, and Vv(nuc/tis) were of significant or marginally significant prognostic value in univariate analyses, whereas no prognostic significance was attributed to estimates of aH(nuc). In multivariate Cox analyses, the clinical stage of disease, vv(nuc), MI, and NI were of significant independent, prognostic value. On the basis of the multivariate analyses, a prognostic index with highly distinguishing capacity between prognostically poor and favorable cases was constructed.


CONCLUSIONS
Quantitative histopathologic variables are of value for objective grading of malignancy in lobular carcinomas. The new parameter--estimates of the mean nuclear volume--is highly reproducible and suitable for routine use. However, larger and prospective studies are needed to establish the true value of the quantitative histopathologic variables in the clinical management of patients with breast cancer.
Ladekarl
M
M
Stereological Research Laboratory, University of Aarhus, Denmark.
Sørensen
F B
FB
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy / Q000648:ultrastructure; D018275:Carcinoma, Lobular / Q000401:mortality* / Q000473:pathology* / Q000628:therapy / Q000648:ultrastructure; D002467:Cell Nucleus / Q000648:ultrastructure; D005260:Female; D006801:Humans; D008875:Middle Aged; D008940:Mitotic Index; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis