title: Low proliferative rate of invasive node-negative breast cancer predicts for a favorable outcome: a prospective evaluation of 669 patients.
abstract: This study was designed to compare outcome in terms of disease-free survival (DFS) in women with histologically negative axillary lymph nodes and documented low proliferative rate cancer to other well-defined prognostic factors including type of adjuvant treatment. Between 1988 and 1998, we studied 669 patients with invasive node-negative breast cancer up to 5 cm in size and low proliferative rate measured by flow cytometry to determine S-phase fraction (SPF) or by histochemistry (Ki67/MIB1). At a median follow-up of 53 months, 5-year DFS for the entire group was 94% and did not differ significantly by type of systemic adjuvant treatment: none (133 patients, 95% DFS), tamoxifen (441 patients, 94% DFS), or chemotherapy with doxorubicin and cyclophosphamide (95 patients, 92% DFS). In a multivariate prognostic factor analysis, only tumor size was significant; 5-year DFS was 96% for T1N0 cancer versus 89% for T2N0 cancer (P = 0.01). We have prospectively confirmed that a low rate of proliferation as measured by SPF or MIB1 determination confers an excellent prognosis in invasive node-negative breast cancer up to 5 cm in size, regardless of adjuvant treatment.
authors.affiliation: Charles A. Sammons Cancer Center, Baylor University Medical Center, Fifth Floor-Research, Texas Oncology, P.A., 3535 Worth Street, Dallas, TX 75246, USA. Steve.Jones@usoncology.com
authors.forename: S
authors.initials: S
authors.lastname: Jones
authors.forename: G
authors.initials: G
authors.lastname: Clark
authors.forename: S
authors.initials: S
authors.lastname: Koleszar
authors.forename: G
authors.initials: G
authors.lastname: Ethington
authors.forename: R
authors.initials: R
authors.lastname: Mennel
authors.forename: S
authors.initials: S
authors.lastname: Paulson
authors.forename: B
authors.initials: B
authors.lastname: Brooks
authors.forename: R
authors.initials: R
authors.lastname: Kerr
authors.forename: C
authors.initials: C
authors.lastname: Denham
authors.forename: M
authors.initials: M
authors.lastname: Savin
authors.forename: C
authors.initials: C
authors.lastname: White
authors.forename: J
authors.initials: J
authors.lastname: Blum
authors.forename: R
authors.initials: R
authors.lastname: Kirby
authors.forename: M
authors.initials: M
authors.lastname: Stone
authors.forename: J
authors.initials: J
authors.lastname: Pippen
authors.forename: L
authors.initials: L
authors.lastname: Kitchens
authors.forename: T
authors.initials: T
authors.lastname: George
authors.forename: B
authors.initials: B
authors.lastname: Cooper
authors.forename: G
authors.initials: G
authors.lastname: Peters
authors.forename: S
authors.initials: S
authors.lastname: Knox
authors.forename: M
authors.initials: M
authors.lastname: Grant
authors.forename: H
authors.initials: H
authors.lastname: Cheek
authors.forename: R
authors.initials: R
authors.lastname: Jones
authors.forename: J
authors.initials: J
authors.lastname: Kuhn
authors.forename: Z
authors.initials: Z
authors.lastname: Lieberman
authors.forename: D
authors.initials: D
authors.lastname: Savino
authors.forename: C
authors.initials: C
authors.lastname: Rietz
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D034961:Antigens, Nuclear; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001365:Axilla; D001943:Breast Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D003520:Cyclophosphamide / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009687:Nuclear Proteins / Q000378:metabolism; D011446:Prospective Studies; D016196:S Phase; D015996:Survival Rate; D013629:Tamoxifen / Q000627:therapeutic use
chemical_list: D000903:Antibiotics, Antineoplastic; D034961:Antigens, Nuclear; D018906:Antineoplastic Agents, Alkylating; D018931:Antineoplastic Agents, Hormonal; D019394:Ki-67 Antigen; D009687:Nuclear Proteins; D013629:Tamoxifen; D004317:Doxorubicin; D003520:Cyclophosphamide