title: Prognostic value of mitotic counts in axillary node negative breast cancer patients with predominantly well-differentiated tumours.
abstract: OBJECTIVE
  In axillary node negative (ANN) breast cancer patients additional prognostic markers are needed to decide whether adjuvant systemic treatment might be useful.
  
  
  METHODS
  In the present study, the prognostic relevance of mitotic counts and Bloom-Richardson grade (BR-grade) was evaluated in 164 ANN breast cancer patients. No adjuvant systemic treatment was given to any of these patients. Mitotic counts were determined twice, in routine practice and in revision.
  
  
  RESULTS
  A substantial reproducibility of mitotic counts was found, provided that the cut-off value chosen was high enough. After a median follow-up of 10 years, mitotic counts had no prognostic significance for survival at any cut-off value. A trend towards a significant worse survival was found for patients with Bloom-Richardson grade II or III in comparison with grade I.
  
  
  CONCLUSIONS
  Based on data in the literature a positive association between both mitotic counts and BR-grade and survival in ANN breast cancer may exist, but the extent of this putative association and its clinical relevance can be argued, particularly in a group of patients with predominantly well differentiated tumours.
authors.affiliation: Department of Clinical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. we.fiets@wanadoo.nl
authors.forename: W E
authors.initials: WE
authors.lastname: Fiets
authors.forename: F E
authors.initials: FE
authors.lastname: Bellot
authors.forename: H
authors.initials: H
authors.lastname: Struikmans
authors.forename: M A
authors.initials: MA
authors.lastname: Blankenstein
authors.forename: J W R
authors.initials: JW
authors.lastname: Nortier
mesh_terms: D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D008940:Mitotic Index; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D013223:Statistics as Topic; D016019:Survival Analysis; D016387:Women's Health