Is DNA ploidy an independent prognostic indicator in infiltrative node-negative breast adenocarcinoma?

Abstract

To evaluate DNA content as an independent, long-term prognostic indicator in infiltrative, node-negative adenocarcinoma of the breast, flow cytometric DNA analyses were performed retrospectively in 165 patients. The exclusive use of paraffin-embedded tissue permitted the study of patients for whom 3 to 15 years' follow-up was available. Other investigators have shown a relationship between DNA nuclear content and well-known prognostic indicators of breast carcinoma, such as estrogen receptors, age, menopausal status, and stage of tumor. However, very few of these studies were based on patients with long-term clinical follow-up and investigated the independent prognostic value of DNA nuclear content. The frequency of aneuploidy in the patients in this study was 57%, with DNA indices ranging from 0.73 to 2.59. Survival in patients with localized breast carcinoma with DNA aneuploid tumors was 84.1% at 5 years and 75.5% at 10 years. Those with diploid tumors showed survival of 87.8% at 5 years and 73.4% at 10 years. These data show no independent prognostic value for DNA nuclear content. The relationship between DNA content, tumor histologic type, and age was also investigated. High-grade tumors were more often aneuploid. There was no association between DNA content and age. Of 165 patients, information regarding estrogen receptor status was available in only 77; 45% of those with aneuploid tumors and 35% with diploid tumors were estrogen receptor-negative. This difference was not significant. The authors conclude that simple determination of DNA ploidy fails to indicate prognosis for infiltrative, node-negative breast carcinoma.

Prognostic significance of flow cytometric DNA analysis and estrogen receptor content in breast carcinomas — a 10 year survival study

“…Reports on the prognostic value of ploidy status as determined by flow cytometry have been inconsistent (see review by Frierson [15]). In studies where overall survival was followed up for periods comparable with that in the present investigation, significantly better survival rates have been found for diploid cases than for nondiploid cases by Kallioniemi et al [16], Toikkanen et al [17], and Lewis [18], whereas, like us, Beerman et al [19], Muss et al [20], and Keyhani-Rofaga et al [21] found no significant difference in survival between diploid and non-diploid node-negative cases. In node-positive cases, Kallioniemi et al [16] and Beerman et al [19] found diploid cases to manifest significant survival advantage, whereas, like us, Toikkanen et al [ 17] did not.…”

Correlation of tumor size and axillary lymph node involvement with prognosis in patients with T1 breast carcinoma

“…However, at this time, tumor size and lymph node status remain the most important prognostic factors in patients with early stage breast carcinoma. [12][13][14][15][16][17][18] It should be noted that in a study of mammographically detected tumors that pathologically measured Ͻ 1.0 cm in size the incidence of axillary lymph node metastasis was 3%, 24 which is similar to our finding of no positive lymph nodes in the 15 patients with small, mammographically detected breast carcinoma.…”

Prognostic value of DNA ploidy in 653 Japanese women with node-negative breast cancer

“…5,10 There 10 Paraffin 165 P Ͻ 0.0001 a Muss 16 Frozen 101 51 NS NS NS NS Clark et al 11 Frozen 345 59 P ϭ 0.02 NS P ϭ 0.02 NS Clark et al 11 Paraffin 298 b NS NS Toikkanen et al 12 Paraffin 158 336 P ϭ 0.01 NS Sigurdsson et al 18 250 48 NS NS O'Reilly et al 19 Paraffin 136 c 96 NS Beerman et al 20 Frozen/paraffin 349 84 NS Keyhani-Rofagha et al 21 Paraffin 165 103 NS Winchester et al 22 Paraffin 257 80 NS NS Merkel et al 23 Paraffin 280 76 NS Balslev et al 13 Frozen 10 demonstrated DNA ploidy to have a prognostic significance in ER-positive tumors, but not in ER-negative tumors, in patients with stage I-III breast cancer. In the present study, multivariate analysis showed the prognostic significance of DNA ploidy, in terms of DFS, in ER-positive breast cancer specimens, but not in ER-negative breast cancer specimens.…”

“…[5][6][7] The prognostic value of DNA ploidy has also been extensively studied in Western women with node-negative breast cancer; however, the results have not been consistent. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Some studies have shown that patients with aneuploid tumors have a significantly worse clinical outcome, [9][10][11][12][13][14][15] whereas others have shown DNA ploidy to have no prognostic value. [16][17][18][19][20][21][22][23] A few studies have reported the relationship between DNA ploidy and the clinical outcome in Japanese patients with breast cancer.…”