DNA FLOW-CYTOMETRY IN NODE-POSITIVE BREAST-CANCER - PROGNOSTIC VALUE AND CORRELATION WITH MORPHOLOGIC AND CLINICAL FACTORS

OBJECTIVE: To help clarify the possible usefulness of nuclear DNA cont ent and S-phase fraction (SPF) as additional prognostic factors in nod e-positive breast cancer patients because there is increased interest in the development of new factors that might provide more detailed pro gnostic information. STUDY DESIGN: We performed a DNA and SPF analysis by flow cytometry using a multivariate statistical model on a group o f 139 node-positive breast cancer patients with clearly defined inclus ion and exclusion criteria. RESULTS: The percentage of aneuploidy incr eased with the number of involved nodes. Aneuploid tumors were move of ten found among grade 3 and among receptor-negative tumors. Univariate analysis showed a strong effect on recurrence-free survival (RFS) for the number of involved nodes (P < .001) and for tumor size (P = .013) . Grade 3 and receptor-negative tumors showed a nonsignificant trend t oward increased risk. The relative risk of aneuploid tumors ions 1.19 (95% confidence interval, 0.75-1.87). Multivariate analysis revealed o nly the number of involved nodes to be an independent prognostic facto r (P = .002); ploidy showed no effect (P = .684). SPF did not show any significant effect on RFS, even in a univariate analysis. CONCLUSION: These results suggest that nuclear DNA content and SPF correlate with morphologic factors. Their routine clinical use, however, in node-pos itive breast cancer patients receiving adjuvant therapy seems to have no clinical relevance and therefore can be omitted.