Biological factors of prognostic significance in locally advanced breast cancer (original) (raw)

Summary

The biological features of tumour type, histological grade, vascular invasion, mitotic index, DNA index, and oestrogen receptor (ER) and progesterone receptor (PgR) status have been investigated as prognostic factors in primary operable breast cancer. We have studied these 7 factors in locally advanced primary breast cancer (LAPC): these patients have occult metastases at presentation.

Of 60 consecutive patients presenting with locally advanced disease, 36 were treated initially with Tamoxifen and 24 by radiotherapy. Treatment failure was followed by cross-over to the other therapy. All patients were assessed for response in the primary tumour; external review of response was obtained. Survival was compared using the generalised Wilcoxon test.

Response to therapy correlated significantly with histological grade (p = 0.02), ER (p = 0.02), PgR status (p = 0.02), mitotic index (p = 0.01), and tumour ploidy (p = 0.04). Survival from initial therapy correlated significantly with ER (p = 0.01) and PgR status (p = 0.04).

Histological grade, mitotic index, tumour ploidy, and ER and PgR status of the primary tumour predict response and prognosis in patients with locally advanced (stage III) breast cancer.

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References

  1. Haybittle JL, Blamey RW, Elston CW, Johnson J, Doyle PJ, Campbell FC, Nicholson RI, Griffiths K: A prognostic index in primary breast cancer. Br J Cancer 45: 361–366, 1982
    Google Scholar
  2. Todd JH, Dowle C, Williams MR, Elston CW, Ellis IO, Hinton CP, Blamey RW, Haybittle JL: Confirmation of a prognostic index in primary breast cancer. Br J Cancer 56: 489–492, 1987
    Google Scholar
  3. Williams MR, Todd JH, Nicholson RI, Elston CW, Blamey RW, Giffiths K: Survival patterns in hormone treated advanced breast cancer. Br J Surg 73: 752–755, 1986
    Google Scholar
  4. Robertson JFR, Nicholson RI, Dixon AR, Ellis IO, Elston CW, Blamey RW: Confirmation of a prognostic index for metastatic breast cancer. Br Cancer Res Treat 22: 221–227, 1992
    Google Scholar
  5. Elston CW: The assessment of histological differentiation in breast cancer. Aust NZ J Surg 54: 11–15, 1984
    Google Scholar
  6. Greene GL, Nolan C, Engler JP, Jensen EV: Monoclonal antibodies to human oestrogen receptor. Proc Natl Acad Sci USA 77: 5115–5119, 1980
    Google Scholar
  7. Nicholson RI, Colin P, Francis AB, Keshra R, Finlay P, Williams M, Elston CW, Blamey RW, Griffiths K: Evaluation of an enzyme immunoassay for estrogen receptors in human breast cancers. Cancer Res 46: 4299s-4302s, 1986
    Google Scholar
  8. Hayward JL, Carbone PP, Heuson JC, Kumaoka S, Segaloff A, Rubens RD: Assessment of response to therapy in advanced breast cancer: a project of the programme on clinical oncology of the International Union Against Cancer, Geneva, Switzerland. Cancer 39: 1289–1294, 1977
    Google Scholar
  9. British Breast Group: Assessment of response to treatment in advanced breast cancer. Lancet ii: 38–39, 1974
    Google Scholar
  10. Howell A, MacIntosh J, Jones M, Redford J, Wagstaff J, Sellwood RA: The definition of the ‘no change’ category in patients treated with endocrine therapy and chemotherapy for advanced carcinoma of the breast. Eur J Cancer Clin Oncol 24: 1567–1572, 1988
    Google Scholar
  11. Robertson JFR, Williams MR, Todd J, Nicholson RI, Morgan DAL, Blamey RW: Factors predicting the response of patients with advanced breast cancer to endocrine (Megace) therapy. Eur J Cancer Clin Oncol 25: 469–475, 1989
    Google Scholar
  12. Rubens RD, Armitage P, Winter PJ, Tong D, Hayward JL: Prognosis in inoperable stage III carcinoma of the breast. Eur J Cancer 13: 805–811, 1977
    Google Scholar
  13. Williams MR, Gilson D, Marsh L, Morgan DAL, Nicholson RI, Elston CW, Griffiths K, Blamey RW: The early results from a randomised study of radiotherapy versus Nolvadex (Tamoxifen) as initial treatment for stage III breast cancer. Eur J Surg Oncol 14: 235–240, 1988
    Google Scholar
  14. Armitage NC, Robertson JFR, Williams MR, Morgan DAL, Nicholson RI, Elston CW, Blamey RW: A randomised trial comparing radiotherapy and tamoxifen as primary treatment for locally advanced breast cancer. Br J Cancer (suppl xii) 62: 8, 1990
    Google Scholar
  15. Galea MH, Blamey RW, Elston CW, Ellis IO: The Nottingham Prognostic Index in primary breast cancer. Br Cancer Res Treat 22: 207–219, 1992
    Google Scholar

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Authors and Affiliations

  1. Tenovus Institute, Cardiff, UK
    RI Nicholson
  2. Department of Surgery, City Hospital, Nottingham, UK
    JFR Robertson, IO Ellis, D Pearson, CW Elston, RI Nicholson & RW Blamey

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  1. JFR Robertson
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  2. IO Ellis
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  3. D Pearson
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  4. CW Elston
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  5. RI Nicholson
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  6. RW Blamey
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Robertson, J., Ellis, I., Pearson, D. et al. Biological factors of prognostic significance in locally advanced breast cancer.Breast Cancer Res Tr 29, 259–264 (1994). https://doi.org/10.1007/BF00666479

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