title: DNA flow cytometry does not predict 5- or 10-year recurrence rates for T1-2 node-negative breast cancer.
abstract: BACKGROUND
  A small proportion of T1 or T2 node-negative breast cancer tumors will recur in patients by 5 years, and more by 10 years. Results of recent studies have suggested improvement in overall survival with administration of adjuvant chemotherapy to all patients. More sensitive and specific methods are needed to identify patients at highest risk for recurrence who might benefit most from adjuvant therapy, saving others from unnecessary treatment. Some investigators have suggested DNA flow cytometry as a method to discriminate patients at greatest risk for recurrence.
  
  
  OBJECTIVE
  DNA flow cytometry has predictive value for breast cancer recurrence in node-negative patients.
  
  
  METHODS
  The cancer registry of a medium-sized university-affiliated hospital was used to identify patients with T1-2 N0 M0 breast cancer treated with a uniform surgical approach and no adjuvant therapy who had completed at least 5 years of follow-up or had recurrence. Flow cytometric analysis was performed on paraffin-embedded specimens.
  
  
  RESULTS
  Of 115 patients, 92 (80%) had disease-free survival without recurrence and 23 (20%) had recurrence. Comparison of diploid and nondiploid tumors for likelihood of recurrence revealed no association (P = .79). Furthermore, the DNA index and S-phase fraction were not significantly different between recurrent and nonrecurrent groups.
  
  
  CONCLUSIONS
  The likelihood of recurrence of small node-negative breast cancers after mastectomy cannot be accurately predicted on the basis of DNA flow cytometric analysis. Traditional methods for determining risks-such as nuclear and histological grade, lymph node status, and tumor size-seem to be more useful. Sentinel lymph node biopsy techniques may increase the detection of micrometastases.
authors: Department of Surgery, Michigan State University College of Human Medicine, PO Box 115, Flint, MI 48501-0115, USA. agspc@aol.com
authors: D N
authors: DN
authors: Reed
authors: J
authors: J
authors: Johnson
authors: P
authors: P
authors: Richard
authors: S
authors: S
authors: McCormick
authors: N
authors: N
authors: Shannon
authors: R A
authors: RA
authors: Mikhail
authors: J
authors: J
authors: Osuch
authors: P B
authors: PB
authors: Cerrito
authors: K M
authors: KM
authors: McMasters
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000235:genetics*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D013997:Time Factors
chemical_list: D004273:DNA, Neoplasm