AN IMPROVED STATISTICAL APPROACH - CAN IT CLARIFY THE ROLE OF NEW PROGNOSTIC FACTORS FOR BREAST-CANCER

Recently, there has been a proliferation of new biomarkers, some of wh ich may lead to an improved prognostic index or may influence treatmen t selection. However, there are methodological and statistical issues that require attention in assessing the role and use of these prognost ic factors. Between 1977 and 1986, 1097 primary breast cancer patients were accrued for multidisciplinary research at the Henrietta Banting Breast Centre, Women's College Hospital; follow-up to 1990 is complete for 96% of the patients. Data for these patients are used here to ill ustrate strategies: (1) for the comparison of results from diverse ass essments of biomarkers; (2) for the improved comparability of inter-la boratory results; (3) for the examination of the results from monoclon al or polyclonal antibody assays for possible clinically relevant bimo dality; (4) for good statistical resolution of overlapping distributio ns; (5) that involve the use of quantitative values for prognostic fac tors whenever possible; and (6) for improved multivariate analyses. Go od data handling and analyses may enable more accurate and rapid asses sment of new prognostic factors, thereby expediting and improving thei r clinical application. Copyright (C) 1996 Elsevier Science Ltd