Skip to main content
SpringerLink
Log in

Routinely available indicators of prognosis in breast cancer

  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Diagnosis coupled with prognostication is the challenge for and charge of the pathologist. In this time of rapidly developing basic knowledge and increasing sophistication in the evaluation of prognostic information, there has also been an important re- evaluation of the validity, reliability, and relevance of classic histopathology. Also, the precision of and criteria for evaluating tumor size and status of regional lymph nodes is under study. Our emphasis in this review is tissue pathology and further, its practical relevance to patient management. Histopathology remains the basis of diagnosis universally; the addition of other elements will increase precision of prediction, particularly of responsiveness to individual therapies. Histologic grade may be integrated to substratify high and low stage cases into prognostically more useful subsets. Histologic types also interact with size and nodal status to predict patients with excellent prognosis. Further refinement of these parameters may occur by analysis within clinical, pathologic, or therapeutic subsets.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Fleming ID, Cooper JS, Henson DE, Hutter RVP, Kennedy BJ, Murphy GP, O'Sullivan B, Sobin LH, Yarbro JW: AJCC Cancer Staging Manual (5th ed). Lippincott-Raven, Philadelphia, 1997

    Google Scholar 

  2. Page DL: Prognosis and breast cancer — Recognition of lethal and favorable prognostic types. Am J Surg Pathol 15:334–349, 1991

    Google Scholar 

  3. Rosen PP, Groshen S, Saigo P, Kinne DW, Hellman S: A long-term follow-up study of survival in Stage I (T1N0M0) and stage II (T1N1M0) breast carcinoma. J Clin Oncol 7:355–366, 1989

    Google Scholar 

  4. Simpson JF, Page DL: The role of pathology in premalignancy and as a guide for treatment and prognosis in breast cancer. Semin Oncol 23:428–435, 1996

    Google Scholar 

  5. Dorr FA: Prognostic factors observed in current clinical trials. Cancer 71:2163–2168, 1993

    Google Scholar 

  6. Roberti NE: The role of histologic grading in the prognosis of patients with carcinoma of the breast — Is this a neglected opportunity? Cancer 80:1708–1716, 1997

    Google Scholar 

  7. Hayes DF, Bast RC, Desch CE, Fritsche H Jr, Kemeny NE, Jessup JM, Locker GY, Macdonald JS, Mennel RG, Norton L, Ravdin P, Taube S, Winn RJ: Tumor marker utility grading system: a framework to evaluate clinical utility of tumor markers. J Natl Cancer Inst 88:1456–1466, 1996

    Google Scholar 

  8. Gasparini G, Pozza F, Harris AL: Evaluating the potential usefulness of new prognostic and predictive indicators in node-negative breast cancer patients. J Natl Cancer Inst 85:1206–1219, 1993

    Google Scholar 

  9. Sloane JP, Anderson TJ, Davies JD, Ellis IO, Elston CW, Millis RR, Wells CA (for the National Coordinating Committee for Breast Screening Pathology:) Pathology reporting in breast cancer screening. National Health Service Breast Screening Programme, Sheffield, UK, 1995

    Google Scholar 

  10. Henson DE, Fielding LP, Grignon DJ, Page DL, Hammond ME, Nash G, Pettigrew NM, Gorstein F, Hutter RV, for the Cancer Committee C: College of American Pathologists Conference XXVI on clinical relevance of prognostic markers in solid tumors. Summary. Arch Pathol Lab Med 119:1109–1112, 1995

    Google Scholar 

  11. Connolly JL, Fechner RE, Kempson RL, Livolsi VA, Page DL, Patchefsky AA, Silverberg SG, for ADASP: Recommendations for the reporting of breast carcinoma. Hum Pathol 27:220–224, 1996

    Google Scholar 

  12. Wells WA, Carney PA, Eliassen MS, Tosteson AN, Greenberg ER: Statewide study of diagnostic agreement in breast pathology. J Natl Cancer Inst 90 (in press)

  13. Page DL, Jensen RA, Simpson JF: Premalignant and malignant disease of the breast. The role of the pathologist. Mod Pathol Feb 1998 (in press)

  14. Page DL, Dupont WD, Jensen RA, Simpson JF: When and to what end do pathologists agree? J Natl Cancer Inst 90 (in press)

  15. Dalton LW, Page DL, Dupont WD: Histologic grading of breast carcinoma. A reproducibility study. Cancer 73:2765–2770, 1994

    Google Scholar 

  16. Baak JP: Mitosis counting in tumors. Hum Pathol 21:683–685, 1990

    Google Scholar 

  17. Ellis IO, Galea M, Broughton N, Locker A, Blamey RW, Elston CW: Pathological prognostic factors in breast cancer. II. Histological type. Relationship with survival in a large study with long-term follow-up. Histopathology 20:479–489, 1992

    Google Scholar 

  18. Page DL, Anderson TJ: How should we categorize breast cancer? The Breast 2:217–219, 1993

    Google Scholar 

  19. Pereira H, Pinder SE, Sibbering DM, Galea MH, Elston CW, Blamey RW, Robertson J, Ellis IO: Pathological prognostic factors in breast cancer. IV. Should you be a typer or a grader? A comparative study of two histological prognostic features in operable breast carcinoma. Histopathology 27:219–226, 1995

    Google Scholar 

  20. Simpson JF, Page DL: Prognostic value of histopathology in the breast. Semin Oncol 19:254–262, 1992

    Google Scholar 

  21. Pinder SE, Ellis IO, Elston CW: Prognostic factors in primary breast carcinoma. J Clin Pathol 48:981–983, 1995

    Google Scholar 

  22. Jensen ML, Kiaer H, Andersen J, Jensen V, Melsen F: Prognostic comparison of three classifications for medullary carcinomas of the breast. Histopathology 30:523–532, 1997

    Google Scholar 

  23. Elston CW, Ellis IO: Method for grading breast cancer. J Clin Pathol 46:189–190, 1993

    Google Scholar 

  24. Koscielny S, Tubiana M, Le MG, Valleron AJ, Mouriesse H, Contesso G, Sarrazin D: Breast cancer relationship between the size of the primary tumour and the probability of metastatic dissemination. Br J Cancer 49:709–715, 1984

    Google Scholar 

  25. Tubiana M, Pejovic MJ, Renaud A, Contesso G, Chavaudra N, Gioanni J, Malaise EP: Kinetic parameters and the course of the disease in breast cancer. Cancer 47:937–943, 1981

    Google Scholar 

  26. Silvestrini R, Daidone MG, Luisi A, Boracchi P, Mezzetti M, Di Fronzo G, Andreola S, Salvadori B, Veronesi U: Biologic and clinicopathologic factors as indicators of specific relapse types in node-negative breast cancer. J Clin Oncol 13:697–704, 1995

    Google Scholar 

  27. Fisher ER, Gregorio RM, Fisher B: The pathology of invasive breast cancer. A syllabus derived from findings of the National Surgical Adjuvant Breast Project (Protocol no 4). Cancer 36:1–85, 1975

    Google Scholar 

  28. Holland PA, Walls J, Boggis CR, Knox F, Baildam AD, Bundred NJ: A comparison of axillary node status between cancers detected at the prevalence and first incidence breast screening rounds. Br J Cancer 74:1643–1646, 1996

    Google Scholar 

  29. Dixon JM, Page DL, Anderson TJ, Lee D, Elton RA, Stewart HJ, Forrest AP: Long-term survivors after breast cancer. Br J Surg 72:445–448, 1985

    Google Scholar 

  30. Gallager HS: Pathologic types of breast cancer: their prognoses. Cancer 53:623–629, 1984

    Google Scholar 

  31. Dixon JM, Anderson TJ, Page DL, Lee D, Duffy SW: Infiltrating lobular carcinoma of the breast. Histopathol 6:149–161, 1982

    Google Scholar 

  32. du Toit RS, Locker AP, Ellis IO, Elston CW, Nicholson RI, Blamey RW: Invasive lobular carcinomas of the breast — the prognosis of histopathological subtypes. Br J Cancer 60:605–609, 1989

    Google Scholar 

  33. Toikkanen S, Pylkkanen L, Joensuu H: Invasive lobular carcinoma of the breast has better short-and long-term survival than invasive ductal carcinoma. Br J Cancer 76:1234–1240, 1997

    Google Scholar 

  34. Knorr KL, Hilsenbeck SG, Wenger CR, Pounds G, Oldaker T, Vendely P, Pandian MR, Harrington D, Clark GM: Making the most of your prognostic factors. Presenting a more accurate survival model for breast cancer patients. Breast Cancer Res Treat 22:251–262, 1992

    Google Scholar 

  35. Henson DE, Fielding LP, Grignon DJ, Page DL, Hammond ME, Nash G, Pettigrew NM, Gorstein F, Hutter RV, for the Cancer Committee CAP: College of American Pathologists Conference XXVI on clinical relevance of prognostic markers in solid tumors. Arch Pathol Lab Med 119:1109–1112, 1995

    Google Scholar 

  36. Sauerbrei W, Hubner K, Schmoor C, Schumacher M: Validation of existing and development of new prognostic classification schemes in node negative breast cancer. Breast Cancer Res Treat 42:149–163, 1997

    Google Scholar 

  37. Goldhirsch A, Wood WC, Seen H-J, Glick JH, Gelber RD: International consensus panel on the treatment of primary breast cancer. Eur J Can 31A:1754–1759, 1995

    Google Scholar 

  38. Veronesi U, Zurrida S: Breast cancer surgery a century after Halsted [review]. J Cancer Res Clin Oncol 122:74–77, 1996

    Google Scholar 

  39. Hermanek P, Sobin LH, Fleming ID: What do we need beyond TNM? Cancer 77:815–817, 1996

    Google Scholar 

  40. Galea MH, Blamey RW, Elston CE, Ellis IO: The Nottingham Prognostic Index in primary breast cancer. Breast Cancer Res Treat 22:207–219, 1992

    Google Scholar 

  41. Robertson JFR, Dixon AR, Nicholson RI, Ellis IO, Elston CW, Blamey RW: Confirmation of a prognostic index for patients with metastatic breast cancer treated by endocrine therapy. Breast Cancer Res Treat 22:221–227, 1992

    Google Scholar 

  42. Barbareschi M, Caffo O, Veronese S, Leek RD, Fina P, Fox S, Bonzanini M, Girlando S, Morelli L, Eccher C, Pezzella F, Doglioni C, Dalla Palma P, Harris A: Bcl-2 and p53 expression in node-negative breast carcinoma: a study with long-term follow-up. Hum Pathol 27:1149–1155, 1996

    Google Scholar 

  43. Schnitt SJ, Abner A, Gelman R, Connolly JL, Recht A, Duda RB, Eberlein TJ, Mayzel K, Silver B, Harris JR: The relationship between microscopic margins of resection and the risk of local recurrence in patients with breast cancer treated with breast-conserving surgery and radiation therapy. Cancer 74:1746–1751, 1994

    Google Scholar 

  44. Connolly JL, Harris JR, Schnitt SJ: Understanding the distribution of cancer within the breast is important for optimizing breast-conserving treatment. Cancer 76:1–3, 1995

    Google Scholar 

  45. Schnitt SJ, Hayman J, Gelman R, Eberlein TJ, Love SM, Mayzel K, Osteen RT, Nixon AJ, Pierce S, Connolly JL, Cohen P, Schneider L, Silver B, Recht A, Harris JR: A prospective study of conservative surgery alone in the treatment of selected patients with stage I breast cancer. Cancer 77:1094–1100, 1996

    Google Scholar 

  46. Veronesi U, Marubini E, Del Vecchio M, Manzari A, Andreola S, Greco M, Luini A, Merson M, Saccozzi R, Rilke F, Salvadori B: Local recurrences and distant metastases after conservative breast cancer treatments: Partly independent events. J Natl Cancer Inst 87:19–27, 1995

    Google Scholar 

  47. Nixon AJ, Schnitt SJ, Gelman R, Gage I, Bornstein B, Hetelekidis S, Recht A, Silver B, Harris JR, Connolly JL: Relationship of tumor grade to other pathologic features and to treatment outcome of patients with early stage breast carcinoma treated with breast-conserving therapy. Cancer 781426–1431, 1996

    Google Scholar 

  48. Arnesson L-G, Hatschek T, Smeds S, Grontoft O: Histopathology grading in small breast cancers <10mm — results from an area with mammography screening. Breast Cancer Res Treat 44:39–46, 1997

    Google Scholar 

  49. Lee AKC, Loda M, Mackarem G, Bosari S, DeLellis RA, Heatley GJ, Hughes K: Lymph node negative invasive breast carcinoma 1 centimeter or less in size (T1aN0M0): clinicopathologic features and outcome. Cancer 76:761–771, 1996

    Google Scholar 

  50. Chadha M, Chabon AB, Friedmann P, Vikram B: Predictors of axillary lymph node metastases in patients with T1 breast cancer: a multivariate analysis. Cancer 73:350–353, 1994

    Google Scholar 

  51. Miller WR, Ellis IO, Sainsbury J, Dixon JM: ABC of breast diseases: Prognostic factors. Br Med J 309:1573–1576, 1994

    Google Scholar 

  52. Mansour EG, Ravdin PM, Dressler L: Prognostic factors in early breast carcinoma. Cancer 74:381–400, 1994

    Google Scholar 

  53. Seidman JD, Schnaper LA, Aisner SC: Relationship of the size of the invasive component of the primary breast carcinoma to axillary lymph node metastasis. Cancer 75:65–71, 1995

    Google Scholar 

  54. Balslev I, Axelsson CK, Zedeler K, Rasmussen BB, Carstensen B, Mouridsen HT: The Nottingham Prognostic Index applied to 9,149 patients from the studies of the Danish Breast Cancer Cooperative Group (DBCG). Breast Cancer Res Treat 32:281–290, 1994

    Google Scholar 

  55. Carter CL, Allen C, Henson DE: Relation of tumor size, lymph node status and survival in 24,740 breast cancer cases. Cancer 63:181–187, 1989

    Google Scholar 

  56. Henson DE: Cancer patient staging: a perspective. Arch Pathol Lab Med 115:120–121, 1991

    Google Scholar 

  57. Kollias J, Elston CE, Ellis IO, Robertson JFR, Blamey RW: Early-onset breast cancer — histopathological and prognostic considerations. Br J Cancer 75:1318–1323, 1997

    Google Scholar 

  58. 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 

  59. Ambros RA, Trost RC: Cellularity in breast carcinoma. Am J Clin Pathol 93:98–100, 1990

    Google Scholar 

  60. Collan YU, Eskelinen MJ, Nordling SA, Lipponen P, Pesonen E, Kumpusalo LM, Pajarinen P, Kettunen KO: Prognostic studies in breast cancer — Multivariate combination of nodal status, proliferation index, tumor size, and DNA ploidy. Acta Oncol 33:873–878, 1994

    Google Scholar 

  61. Quiet CA, Ferguson DJ, Weichselbaum RR, Hellman S: Natural history of node-positive breast cancer: the curability of small cancers with a limited number of positive nodes. J Clin Oncology 14:3105–3111, 1996

    Google Scholar 

  62. Van Bogaert L-J: Immunohistochemical detection and significance of axillary lymph node micrometastases in breast carcinoma. Analyt Quant Cytol Histol 17:75–76, 1995

    Google Scholar 

  63. Siegel RJ: Surgical pathology of lymph nodes in cancer staging routine and specialized techniques [review]. Surg Oncol Clin N Am 5:25–31, 1996

    Google Scholar 

  64. de Mascarel I, Bonichon F, Coindre JM, Trojani M: Prognostic significance of breast cancer axillary lymph node micrometastases assessed by two special techniques: reevaluation with longer follow-up. Br J Cancer 66:523–527, 1992

    Google Scholar 

  65. Donegan WL, Stine SB, Samter TG: Implications of extracapsular nodal metastases for treatment and prognosis of breast cancer. Cancer 72:778–782, 1993

    Google Scholar 

  66. Anderson TJ, Lamb J, Alexander F, Lutz W, Chetty U, Forrest AP, Kirkpatrick A, Muir B, Roberts MM, Huggins A: Comparative pathology of prevalent and incident cancers detected by breast screening. Lancet 1:519–522, 1986

    Google Scholar 

  67. Carriaga MT, Henson DE: The histologic grading of cancer. Cancer 75:406–421, 1995

    Google Scholar 

  68. Contesso G, Mouriesse H, Friedman S, Genin J, Sarrazin D, Rouesse J: The importance of histologic grade in long-term prognosis of breast cancer: A study of 1,010 patients, uniformly treated at the Institut Gustave-Roussy. J Clin Oncol 5:1378–1386, 1987

    Google Scholar 

  69. Simpson JF, Page DL: The role of pathology in premalignancy and as a guide for treatment and prognosis in breast cancer. Semin Oncol 23:428–435, 1996

    Google Scholar 

  70. Simpson JF, Page DL: Status of breast cancer prognostication based on histopathologic data. Am J Clin Pathol 102:S3–S8, 1994

    Google Scholar 

  71. Pinder SE, Wencyk P, Sibbering DM, Bell JA, Elston CW, Nicholson R, Robertson J, Blamey RW, Ellis IO: Assessment of the new proliferation marker MIB1 in breast carcinoma using image analysis: Associations with other prognostic factors and survival. Br J Cancer 71:146–149, 1995

    Google Scholar 

  72. Elston CW, Ellis IO: Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term followup. Histopathol 19:403–410, 1991

    Google Scholar 

  73. Frierson HF Jr, Wolber RA, Berean KW, Franquemont DW, Gaffey MJ, Boyd JC, Wilbur DC: Interobserver reproducibility of the Nottingham modification of the Bloom and Richardson histologic grading scheme for infiltrating ductal carcinoma. Am J Clin Pathol 103:195–198, 1995

    Google Scholar 

  74. Anderson TJ, Page DL: Risk assessment in breast cancer. In: Anthony PP, MacSween RNM, Lowe DG (eds) Recent Advances in Histopathology, Vol. 17. Churchill Livingstone, Edinburgh, 1997, pp 69–91

    Google Scholar 

  75. Frierson HF Jr, Wolber RA, Berean KW, Franquemont DW, Gaffey MJ, Boyd JC, WiLbur DC: Interobserver reproducibility of the Nottingham modification of the Bloom and Richardson histologic grading scheme for infiltrating ductal carcinoma. Am J Clin Pathol 103:195–198, 1995

    Google Scholar 

  76. Contesso G, Jotti GS, Bonadonna G: Tumor grade as a prognostic factor in primary breast cancer [review]. Eur J Cancer Clin Oncol 25:403–409, 1989

    Google Scholar 

  77. Le Doussal V, Tubiana-Hulin M, Friedman S, Hacene K, Spyratos F, Brunet M: Prognostic value of histologic grade nuclear components of Scarff-Bloom-Richardson (SBR): An improved score modification based on a multivariate analysis of 1262 invasive ductal breast carcinomas. Cancer 64:1914–1921, 1989

    Google Scholar 

  78. Cooper HS, Patchefsky AS, Krall RA: Tubular carcinoma of the breast. Cancer 42:2334–2342, 1978

    Google Scholar 

  79. McDivitt RW, Boyce W, Gersell D: Tubular carcinoma of the breast: clinical and pathological observations concerning 135 cases. Am J Surg Pathol 6:401–411, 1982

    Google Scholar 

  80. Page DL, Dixon JM, Anderson TJ, Lee D, Stewart HJ: Invasive cribriform carcinoma of the breast. Histopathol 7:525–536, 1983

    Google Scholar 

  81. Parl FF, Richardson LD: The histological and biological spectrum of tubular carcinoma of the breast. Hum Pathol 14:694–698, 1983

    Google Scholar 

  82. Venable JG, Schwartz AM, Silverberg SG: Infiltrating cribriform carcinoma of the breast: a distinctive clinicopathologic entity. Hum Pathol 21:333–338, 1990

    Google Scholar 

  83. Wheeler JE, Enterline HT: Lobular carcinoma of the breast in situ and infiltrating. In: Sommers SC (ed) Pathology Annual, Vol 11, 1976, pp 161–188

  84. Martinez V, Azzopardi JG: Invasive lobular carcinoma of the breast: incidence and variants. Histopathology 3:467–488, 1979

    Google Scholar 

  85. Dixon AR, Ellis IO, Elston CW, Blamey RW: A comparison of the clinical metastatic patterns of invasive lobular and ductal carcinomas of the breast. Br J Cancer 63:634–635, 1991

    Google Scholar 

  86. Borst MJ, Ingold JA: Metastatic patterns of invasive lobular versus invasive ductal carcinoma of the breast. Surgery 114:637–641, 1993

    Google Scholar 

  87. du Toit RS, Locker AP, Ellis IO, Elston CW, Nicholson RI, Robertson JF, Blamey RW: An evaluation of differences in prognosis, recurrence patterns and receptor status between invasive lobular and other invasive carcinomas of the breast. Eur J Surg Oncol 17:251–257, 1991

    Google Scholar 

  88. Holland PA, Shah A, Howell A, Baildam AD, Bundred NJ: Lobular carcinoma of the breast can be managed by breast-conserving therapy. Br J Surg 82:1364–1366, 1995

    Google Scholar 

  89. Jain S, Fisher C, Smith P, Millis RR, Rubens RD: Patterns of metastatic breast cancer in relation to histological type. Eur J Cancer 15:2155–2157, 1993

    Google Scholar 

  90. Kidney DD, Cohen AJ, Butler J: Abdominal metastases of infiltrating lobular breast carcinoma: CT and fluoroscopic imaging findings. Abdominal Imaging 22:156–159, 1997

    Google Scholar 

  91. Lamovec J, Bracko M: Metastatic pattern of infiltrating lobular carcinoma of the breast: an autopsy study. J Surg Oncol 48:28–33, 1991

    Google Scholar 

  92. Taal BG, den Hartog Jager FC, Steinmetz R, Peterse H: The spectrum of gastrointestinal metastases of breast carcinoma. I. Stomach. Gastrointestinal Endoscopy 38:130–135, 1992

    Google Scholar 

  93. Weidner N, Semple JP: Pleomorphic variant of invasive lobular carcinoma of the breast. Hum Pathol 23:1167–1171, 1992

    Google Scholar 

  94. Eusebi V, Magalhaes F, Azzopardi JG: Pleomorphic lobular carcinoma of the breast: an aggressive tumor showing apocrine differentiation. Hum Pathol 23:655–662, 1992

    Google Scholar 

  95. Pedersen L, Holck S, Schiodt T, Zedeler K, Mouridsen HT: Medullary carcinoma of the breast, prognostic importance of characteristic histopathological features evaluated in a multivariate Cox analysis. Eur J Cancer 30A:1792–1797, 1994

    Google Scholar 

  96. Ridolfi RL, Rosen PP, Post A, Kinne T, Mike V: Medullary carcinoma of the breast. A clinical pathological study with 10 year follow-up. Cancer 40:1365–1385, 1977

    Google Scholar 

  97. Pedersen L, Zedeler K, Holck S, Schiodt T, Mouridsen HT: Medullary carcinoma of the breast, proposal for a new simplified histopathological definition. Br J Cancer 63:591–595, 1991

    Google Scholar 

  98. Rapin V, Contesso G, Mouriesse H, Bertin F, Lacombe MJ, Piekarski JD, Travagli JP, Gadenne C, Friedman S: Medullary breast carcinoma. A reevaluation of 95 cases of breast cancer with inflammatory stroma. Cancer 61:2503–2510, 1988

    Google Scholar 

  99. Marcus JN, Watson P, Page DL, Narod SA, Lenoir GM, Tonin P, Linder-Stephenson L, Salerno G, Conway TA, Lynch HT: Hereditary breast cancer: pathobiology, prognosis, and BRCA1 and BRCA2 gene linkage. Cancer 77:697–709, 1996

    Google Scholar 

  100. Clayton F: Pure mucinous carcinomas of breast: Morphologic features and prognostic correlates. Hum Pathol 17:34–38, 1986

    Google Scholar 

  101. Rosen PP, Lesser ML, Kinne DW: Breast carcinoma at the extremes of age: a comparison of patients younger than 35 years and older than 75 years. J Surg Oncol 2890–96, 1985

    Google Scholar 

  102. Fentiman IS, Millis RR, Smith P, Ellul JPM, Lampejo O: Mucoid breast carcinomas: Histology and prognosis. Br J Cancer 75:1061–1065, 1997

    Google Scholar 

  103. Silvestrini R, Daidone MG, Mastore M, Di Fronzo G, Coradini D, Boracchi P, Squicciarini P, Salvadori B, Veronesi U: Cell kinetics as a predictive factor in node-positive breast cancer treated with adjuvant hormone therapy. J Clin Oncol 11:1150–1155, 1993

    Google Scholar 

  104. Silvestrini R, Daidone MG, Luisi A, Mastore M, Leutner M, Salvadori B: Cell proliferation in 3,800 node-negative breast cancers: Consistency over time of biological and clinical information provided by 3H-thymidine labelling index. Int J Cancer 74:122–127, 1997

    Google Scholar 

  105. van Diest PJ, Baak JPA, Matze-Cok P, Wisse-Brekelmans ECM, Van Galen CM, Kurver PHJ, Bellot SM, Fijnheer J, Van Gorp LHM, Kwee WS, Los J, Peterse JL, Ruitenberg HM, Schapers RFM, Schipper MEI, Somsen JC, Willig A, Ariens AT: Reproducibility of mitosis counting in 2,469 breast cancer specimens: Results from the Multicenter Morphometric Mammary Carcinoma Project. Hum Pathol 23:603–607, 1992

    Google Scholar 

  106. Page DL, Simpson JF: Measures of proliferation in breast cancer: practicality and utility. The Breast 6:169–170, 1997

    Google Scholar 

  107. Connor AJM, Pinder SE, Elston CW, Bell JA, Wencyk P, Robertson JFR, Blamey RW, Nicholson RI, Ellis IO: Intratumoral heterogeneity of proliferation in invasive breast cancer evaluated with MIB1 antibody. The Breast 6:171–176, 1997

    Google Scholar 

  108. Jannink I, Risberg B, Van Diest PJ, Baak JP: Heterogeneity of mitotic activity in breast cancer. Histopathology 29:421–428, 1996

    Google Scholar 

  109. Simpson JF, Dutt PL, Page DL: Expression of mitoses per thousand cells and cell density in breast carcinoma: a proposal. Hum Pathol 23:608–611, 1992

    Google Scholar 

  110. Baak JPA, Van Dop H, Kurver PHJ, Hermans J: The value of morphometry to classic prognosticators in breast cancer. Cancer 56:374–382, 1985

    Google Scholar 

  111. Pinder SE, Wencyk P, Sibbering DM, Bell JA, Elston CW, Robertson JF, Nicholson R, Blamey RW, Ellis IO: Assessment of the new proliferation marker MIB1 in breast carcinoma using image analysis: associations with other prognostic factors and survival. Br J Cancer 71: 146–149, 1995

    Google Scholar 

  112. Rudas M, Gnant M, Mittlböck M, Neumayer R, Kummer A, Jakesz R, Reiner G, Reiner A: Thymidine labeling index and Ki-67 growth fraction in breast cancer. Breast Cancer Res Treat 32:165–175, 1994

    Google Scholar 

  113. Ellis PA, Makris A, Burton SA, Titley J, Ormerod MG, Salter J, Powles TJ, Smith IE, Dowsett M: Comparison of MIB-1 proliferation index with S-phase fraction in human breast carcinomas. Br J Cancer 73:640–643, 1996

    Google Scholar 

  114. Simpson JF, Page DL: Cellular proliferation and prognosis in breast cancer: statistical purity versus clinical utility [editorial]. Hum Pathol 25:331–332, 1994

    Google Scholar 

  115. Keshgegian AA, Cnaan A: Proliferation markers in breast carcinoma: Mitotic figure count, S-phase fraction, proliferating cell nuclear antigen, Ki-67 and MIB-1. Am J Clin Pathol 104:42–49, 1995

    Google Scholar 

  116. Leong AS-Y, Lee AKC: Biological indices in the assessment of breast cancer. J Clin Pathol Mol Pathol 48:M221–M238, 1995

    Google Scholar 

  117. Molino A, Micciolo R, Turazza M, Bonetti F, Piubello Q, Corgnati A, Sperotto L, Recaldin E, Spagnolli P, Manfrin E, Bonetti A, Nortilli R, Tomezzoli A, Pollini GP, Modena S, Cetto GL: Prognostic significance of estrogen receptors in 405 primary breast cancers: a comparison of immunohistochemical and biochemical methods. Breast Cancer Res Treat 45:241–249, 1997

    Google Scholar 

  118. Esteban JM, Ahn C, Battifora H, Felder B: Quantitative immunohistochemical assay for hormonal receptors: technical aspects and biological significance. J Cell Biochem 19,S:138–145, 1994

    Google Scholar 

  119. Esteban JM, Ahn C, Battifora H, Felder B: Predictive value of estrogen receptors evaluated by quantitative immunohistochemical analysis in breast cancer. Am J Clin Pathol 102:S9–12, 1994

    Google Scholar 

  120. Parl FF, Posey YF: Discrepancies of the biochemical and immunohistochemical estrogen receptor assays in breast cancer. Hum Pathol 19:960–966, 1988

    Google Scholar 

  121. Davis BW, Gelber R, Goldhirsch A, Hartmann WH, Hollaway L, Russell I, Rudenstam CM: Prognostic significance of peritumoral vessel invasion in clinical trials of adjuvant therapy for breast cancer with axillary lymph node metastasis. Hum Pathol 16:1212–1218, 1985

    Google Scholar 

  122. Lee AK, DeLellis RA, Wolfe HJ: Intramammary lymphatic invasion in breast carcinomas. Evaluation using ABH isoantigens as endothelial markers. Am J Surg Pathol 10:589–594, 1986

    Google Scholar 

  123. Lee AK, DeLellis RA, Silverman ML, Wolfe HJ: Lymphatic and blood vessel invasion in breast carcinoma: a useful prognostic indicator? Hum Pathol 17:984–987, 1986

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Anatomic Pathology, Vanderbilt University Medical Center, Nashville, Tennessee, 37232, USA

    David L. Page, Roy A. Jensen & Jean F. Simpson

  2. Departments of Preventive Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, 37232, USA

    David L. Page & Roy A. Jensen

Authors
  1. David L. Page
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roy A. Jensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jean F. Simpson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David L. Page.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Page, D.L., Jensen, R.A. & Simpson, J.F. Routinely available indicators of prognosis in breast cancer. Breast Cancer Res Treat 51, 195–208 (1998). https://doi.org/10.1023/A:1006122716137

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1006122716137

Search

Navigation