Prognostic significance of DNA ploidy determined by high-resolution flow cytometry in breast carcinoma.
OBJECTIVE
To assess the prognostic value of DNA ploidy in breast carcinoma and its relation to other established prognostic factors.


METHODS
We evaluated DNA ploidy in 303 breast carcinoma patients with a median follow-up of 63 months. Flow cytometry was performed on frozen tumor material, yielding histograms with narrow peaks (median coefficient of variation of 2.08). DNA ploidy pattern was classified as either diploid versus nondiploid, euploid (diploid and tetraploid) versus aneuploid or diploid/near-diploid (DNA index < 1.2) versus other, and correlated with relapse-free (RFS) and cancer-specific survival (CSS) along with tumor size, histologic grade and type, axillary lymph node involvement, menopausal and steroid receptor status, age and type of treatment.


RESULTS
Seventy-one percent of tumors were DNA nondiploid (14% tetraploid and 57% aneuploid). There was a strong association between DNA ploidy and histologic grade. Histologic grade, lymph node status, tumor size and DNA ploidy (regardless of the classification used) were all significantly associated with RFS and CSS in multivariate analysis.


CONCLUSIONS
These results suggest that DNA ploidy, at least when determined from frozen tumor tissue, is an independent prognostic factor in breast carcinoma; however, its prognostic power seems to be inferior to that of histologic grade, with which it strongly correlates.
Departments of Pathology, Cytopathology and Medical Oncology, Institute of Oncology, Zaloska 2, 1105 Ljubljana, Slovenia.
M
M
Bracko
M
M
Us-Krasovec
T
T
Cufer
J
J
Lamovec
A
A
Zidar
W
W
Goehde
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D002453:Cell Cycle; D004273:DNA, Neoplasm; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008875:Middle Aged; D011003:Ploidies; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis
D004273:DNA, Neoplasm