title: [Combined flow cytometry determination of S-phase fraction and DNA ploidy is an independent prognostic factor in node-negative invasive breast carcinoma: review of a series of 271 patients with stage I and II breast cancer].
abstract: OBJECTIVE
  To assess the significance of S-phase fraction (SPF) and DNA ploidy evaluated by DNA flow cytometry as prognostic markers in stage I or II breast cancer.
  
  
  METHODS
  A series of 271 patients, treated by surgery, radiotherapy+/-systemic therapy was analysed (median follow up: 64 months). Standardized flow cytometry cell preparation from frozen samples and consensus rules for data interpretation were followed. Three SPF classes were defined on the basis of tertiles after adjustment for ploidy. Four groups were defined based on combinations of DNA ploidy (DIP: diploid; ANEUP: aneuploid) and SPF: DIP and low SPF (DL, N=37), DIP and medium or high SPF (DMH, N=76), ANEUP and low SPF (AL, N=24), ANEUP and medium or high SPF (AMH, N=68). Local control rate (LCR), disease-free survival (DFS), metastasis-free survival (MFS), and overall survival (OS) were correlated with DNA ploidy, SPF, DL to AMH groups, T and N stages, SBR grading, age, and hormonal status on univariate and multivariate analysis (Cox model).
  
  
  RESULTS
  On univariate analysis, DFS and LCR were higher for DIP tumours. High SPF values were associated with shorter DFS. LCR, MFS, DFS, and OS rates were significantly different with an increasingly poorer prognosis from DL to AMH. On multivariate analysis, groups DL to AMH, histological node involvement and T stage were independently associated with MFS, and DFS. In N- patients, DL to AMH remained independent for MFS and DFS. For SBR III tumours, MFS and OS were significantly different in DL to AMH groups. These results strongly support the use of combined evaluation of DNA ploidy and SPF as independent parameters in clinical trials for N- stage I and II breast cancer.
authors.affiliation: Service d'oncologie radiothérapie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France. laurence.moureau.zabotto@tiscali.fr
authors.forename: L
authors.initials: L
authors.lastname: Moureau-Zabotto
authors.forename: C
authors.initials: C
authors.lastname: Bouchet
authors.forename: D
authors.initials: D
authors.lastname: Cesari
authors.forename: S
authors.initials: S
authors.lastname: Uzan
authors.forename: J P
authors.initials: JP
authors.lastname: Lefranc
authors.forename: M
authors.initials: M
authors.lastname: Antoine
authors.forename: C
authors.initials: C
authors.lastname: Genestie
authors.forename: E
authors.initials: E
authors.lastname: Deniaud-Alexandre
authors.forename: J F
authors.initials: JF
authors.lastname: Bernaudin
authors.forename: E
authors.initials: E
authors.lastname: Touboul
authors.forename: J
authors.initials: J
authors.lastname: Fleury-Feith
mesh_terms: D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000628:therapy; D004273:DNA, Neoplasm / Q000032:analysis*; D018572:Disease-Free Survival; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011003:Ploidies; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D004273:DNA, Neoplasm