Prognostic factors in early breast carcinoma

作者：Edward G. Mansour, Peter M. Ravdin, Lynn G. Dressier · 发表于：Cancer · 年份：1994 · DOI：10.1002/cncr.2820741326 · 被引用次数：200 · 研究领域：Breast Cancer Treatment Studies、Cancer Cells and Metastasis、Cancer Genomics and Diagnostics

Several investigators, the SEER data, and the ECOG/Intergroup study have shown that patients with small tumors (<0.5 cm) have a recurrence rate of less than 2%, compared to 20–25% for large tumors (≥5 cm). Nuclear grade and tumor differentiation are established indicators; however, the interobserver lack of concordance has thwarted their use in clinical trials. The presence of peritumoral lymphatic and blood vessel invasion (PLBI) is associated with a relative risk of recurrence of 4.7. The predictive value of the presence of hormone receptors in tumors is associated with a favorable disease free and overall survival difference of 8–10%; however, this advantage is being eroded by the early appearance of other factors, such as the epidermal growth factor receptor (EGFR), proliferative capacity (S-phase), nuclear grade, and HER-2/neu oncogene. Concordance among the different methods of hormone-receptor assay (immune-cytochemical, sucrose gradient, and dextran-coated charcoal) is essential to refine the true value of these factors. DNA flow cytometry measurements of ploidy (DNA content) and S-phase fraction are the most characterized of the prognostic factors. There are conflicting reports regarding the clinical significance of ploidy status, while measurements of S-phase fraction clearly indicate a robust association with disease free and overall survival. Our data continue to show that S-phase, but not ploidy, can predict time to recurrence significantly in untreated patients,...