Abstract

The value of quantitative histopathologic analysis in prognosis of infiltrating ductal breast carcinoma was assessed. The study was carried out on breast tumours at an early clinical stage, with diameters below 2.5 cm. Ninety cases were studied. At the end of the study there were 45 deceased and 45 surviving patients, the latter with a follow-up of at least 69 months. Quantitative histopathologic analysis was carried out by simultaneously measuring a number of geometric features in the nuclei and nucleoli of each tumour. In addition, mitotic activity and the percentage of immunohistochemically positive cells for proliferating cell nuclear antigen (PCNA) were recorded in each case. The study showed many statistically significant differences (p < 0.05) between the two groups of deceased and surviving patients. However, very few differences were observed when the groups of patients with and without axillary lymph node metastases were compared. Moreover, no significant differences were found between deceased patients with short (≤ 30 months) and long (> 30 months) survival. With multivariate analysis (forward stepwise discriminant analysis) it was possible to produce a canonical discriminant function by which the deceased and surviving patients were correctly classified in 92.2% of the cases. The results stress the usefulness of quantitative methods in the prognostic assessment of breast cancer, as well as the possibility of applying this approach to cytologic material, in order to preoperatively identify patients at high risk for death.

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