Nuclear grade and DNA ploidy in stage IV breast cancer with only visceral metastases at initial diagnosis.
OBJECTIVE
The presence of early metastases to distant sites in breast cancer patients is an infrequent event whose mechanisms are still not clear. The aim of this study was to evaluate the biologic and clinical role of DNA ploidy and cell nuclear grade of primary tumors in the metastatic process of a series of stage IV previously untreated breast cancer patients with only visceral metastases.


METHODS
DNA flow cytometry analysis on paraffin-embedded material and cell nuclear grading of primary tumors was performed on a series of 50 breast cancer patients with only visceral metastases at the time of initial diagnosis.


RESULTS
Aneuploidy was found in 28/46 (61%) of evaluable cases and was independent of site of involvement, clinical response, time of progression and overall survival of patients. Of the 46 cases evaluable for nuclear grade, 5 (11%), 16 (35%) and 25 (54%) were classified as G1 (well-differentiated) G2 and G3, respectively. Nuclear grade also was unrelated to response to therapy and overall survival, whereas time to progression was significantly longer in G1-2 than G3 tumors with the logrank test (P < 0.03) and multivariate analysis.


CONCLUSIONS
Our results seem to stress the difficulty to individualize different prognostic subsets from a series of breast cancer patients with only visceral metastases at initial diagnosis according to DNA flow cytometry and nuclear grade.
Oncology Institute, Bari, Italy.
M
M
De Lena
A
A
Barletta
F
F
Marzullo
M
M
Rabinovich
B
B
Leone
C
C
Vallejo
M
M
Machiavelli
A
A
Romero
J
J
Perez
J
J
Lacava
M A
MA
Cuevas
R
R
Rodriguez
F
F
Schittulli
A
A
Paradisco
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology; D004273:DNA, Neoplasm / Q000235:genetics*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011003:Ploidies; D016016:Proportional Hazards Models; D016019:Survival Analysis
D004273:DNA, Neoplasm