title: Independent prognostic value of hormone receptor expression and S-phase fraction in advanced breast cancer.
abstract: OBJECTIVE
  TO assess the prognostic value of immunocytochemically assessed hormone receptor expression and DNA flow cytometry data in advanced breast cancer.
  
  
  METHODS
  This prospective study with long-term follow-up evaluated the above parameters in relation to overall survival in 392 patients with advanced breast cancer (stages IIB, n = 106; IIIA, n = 66; IIIB, n = 174; and IV, n = 46) using fine needle aspiration cytology.
  
  
  RESULTS
  Estrogen and progesterone receptor positivity was detected in 65.1% and 46.1% of the tumors, respectively. DNA aneuploidy was present in 70.9% of the cases, and the median S-phase fraction (SPF) was 9.4%. There was a significant correlation of aneuploidy and high SPF with lack of hormone receptors. The median SPF and SPF tertiles (cutoff values, 6.5% and 12%), applied in the whole series, showed a significant correlation with survival, whereas if SPF was used according to ploidy status, no prognostic significance was found. No differences in relation to survival among different DNA aneuploidy subclasses were verified. In univariate analysis, clinical staging, hormone receptors, DNA ploidy and SPF showed a statistically significant correlation with the overall survival. In multivariate analysis only DNA ploidy did not maintain independent prognostic significance.
  
  
  CONCLUSIONS
  Hormone receptor expression and flow cytometric SPF are independent prognostic factors in advanced breast cancer.
authors.affiliation: Department of Anatomic Pathology, Instituto Português de Oncologia de Francisco Gentil, Centro de Lisboa, Lisbon, Portugal. apat@ipolisboa.min-saude.pt
authors.forename: António E
authors.initials: AE
authors.lastname: Pinto
authors.forename: Evelina
authors.initials: E
authors.lastname: Mendonça
authors.forename: Saudade
authors.initials: S
authors.lastname: André
authors.forename: Sónia D
authors.initials: SD
authors.lastname: Nóbrega
authors.forename: Jorge
authors.initials: J
authors.lastname: Soares
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000401:mortality; D004273:DNA, Neoplasm / Q000032:analysis*; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006801:Humans; D009367:Neoplasm Staging; D011003:Ploidies; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000032:analysis / Q000378:metabolism*; D016196:S Phase; D015996:Survival Rate
chemical_list: D004273:DNA, Neoplasm; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone