Primary breast cancer: Flow cytometric dna pattern in relation to clinical and histopathologic characteristics

Abstract

Cell suspensions of 59 primary operable mammary carcinomas in women were subjected to flow cytometric DNA analyses. The results were correlated to histopathological grading, clinical staging, menopausal status and estrogen receptor status. Thirty-two tumors showed a DNA peak above +25% of murine lymphocyte level and were named distinct aneuploid (AN). Twenty-seven tumors did not show such a peak and were named near diploid (ND). Low histopathological malignancy grade was associated with a high frequency of ND tumors (P less than 0.05). Small tumors (T1) were predominantly ND (14/19), while larger tumors (T2-3) showed a high frequency of AN tumors (27/40) (P less than 0.01). Tumors occurring in post-menopausal women were often AN, while those arising in premenopausal women were frequently ND (P less than 0.06). No clear correlation was found between the DNA ploidy pattern and estrogen receptor status. There was a tendency that patients with AN tumors had a higher frequency of relapses during the first 4-5 years of follow-up than those with ND breast carcinomas.

The prognostic significance of nuclear DNA content in invasive breast cancer – a study with long-term follow-up

“…Most authors agree that DNA aneuploidy is associated with poor histological grade (Thorud et al, 1986;Moran et al, 1984;Spyratos et al, 1987;Olszewski et al, 1981;Jakobsen et al, 1984;Hedley et al, 1984;McDivitt et al, 1986;Kute et al, 1985;Kallioniemi et al, 1987;Feichter et al, 1988;Dowle et al, 1987), and the mitotic count, nuclear pleomorphism and degree of tubule formation describe much the same thing. The amount of elastin and the extent of necrosis have been associated with histological grade too (Fisher et al, 1984;Kuhajda et al, 1985).…”

“…The occurrence of aneuploidy in histological subtypes of breast cancer has received scant attention; only mucinous carcinomas have been extensively studied (Toikkanen et al, 1988). The percentage of non-diploid tumours was high in medullary (86%) and ductogenic NOS (74%) carcinomas, and low in lobular (43%) and tubular (40%) carcinomas (Table II).…”

“…Most authors (Thorud et al, 1986;Coulson et al, 1984;Hedley et al, 1987;Kallioniemi et al, 1987;Dowle et al, 1987;Cornelisse et al, 1987;Ewers et al, 1984;Stal et al, 1989), but not all (van der Linden et al, 1989;Uyterlinde et al, 1988;Owainati et al, 1987), agree that DNA aneuploidy is associated with unfavourable survival in breast cancer. In most studies this association has, however, been weak.…”

“…The technique has gained some popularity, since flow cytometric histograms are rapid to produce and often easy to interpret. It has been suggested that breast carcinomas with an abnormal (non-diploid or aneuploid) nuclear DNA content are associated with less favourable prognosis than carcinomas with a normal (diploid) DNA content (Hedley et al, 1984(Hedley et al, , 1987Coulson et al, 1984;Ewers et al, 1984;Thorud et al, 1986;Baildam et al, 1987;Cornelisse et al, 1987;Kallioniemi et al, 1987;Stal et al, 1989). Similarly, the DNA index (DI, the relative DNA content of an aneuploid stemline of cells as compared with diploid cells) and the percentage of S-phase cells in the DNA histogram (S-phase fraction, SPF) have been found by some to be of prognostic significance (Dowle et al, 1987;Hedley et al, 1987;Kallioniemi et al, 1988;Stal et al, 1989;McDivitt et al, 1986;Klintenberg et al, 1986).…”

DNA index, S-phase fraction, histological grade and prognosis in breast cancer

“…Many studies have shown correlations between cellular DNA content, as measured by flow cytometry, and other pretreatment factors (Moran et al, 1984;Kute et al, 1985;Thorud et al, 1986;Dressler et al, 1988;Feichter et al, 1988). Fewer have examined the relationship between the results of flow-cytometric DNA analysis, in particular Sphase fraction, and clinical course.…”