BIOLOGIC AND CLINICOPATHOLOGICAL FACTORS AS INDICATORS OF SPECIFIC RELAPSE TYPES IN NODE-NEGATIVE BREAST-CANCER

Purpose and Methods: We evaluated, in 1,800 patients with node-negativ e tumors treated with locoregional therapy until relapse, the competit ive risks for different types of metastasis by cell proliferation (H-3 -thymidine labeling index [H-3-dT LI]), estrogen receptors (ERs), and progesterone receptors (PgRs), and by the integration of biologic and clinicopathologic information. Results: Hormone receptor status and pr oliferative activity of the primary rumor were not indicative of contr alateral failures. Hormone receptors failed to predict the 8-year inci dence of locoregional recurrence, bur they were significant indicators of distant metastasis and overall survival. The latter finding was co nfirmed even in multivariate analysis. Conversely, cell proliferation predicted both locoregional and distant metastases and survival, regar dless of patient age, tumor size, and ER and PgR status. Recursive par titioning and amalgamation analysis ascribed to cell proliferation an important prognostic role for locoregional recurrence together with pa tient age, and for distant metastasis together with patient age and tu mor size. Conclusion: Biologic markers, in particular cell proliferati on, provide information for the different types of relapse and could c omplement the predictive role of pathologic staging. (C) 1995 by Ameri can Society of Clinical Oncology.