THE PROGNOSTIC VALUE OF DNA-PLOIDY AND S-PHASE ESTIMATE IN PRIMARY BREAST-CANCER - A PROSPECTIVE-STUDY

In this prospective study, the independent prognostic value of DNA plo idy in combination with the major clinico-pathological characteristics (histological grade, nodal status, tumor size, estrogen and progester one receptor status, number of tumors, multicentricity, lympho-vascula r infiltration) was evaluated in a series of 399 breast-cancer patient s. The mean follow-up time was 4.5 years. The DNA content was measured using image cytometry on fresh tumor samples. The overall survival of tetraploid and slowly proliferating diploid cases was significantly d ifferent compared with that of aneuploid and rapidly proliferating dip loid cases (P = 0.0002). Thus, DNA ploidy combined with S-phase estima te (DNA histogram type) appeared to be good prognostic factors. In a m ultivariate survival analysis, DNA histogram type was not an independe nt prognostic factor unless the histological grade was excluded. This effect of DNA histogram type on survival was also observed among patie nts with grade-I or -II tumors and patients with small tumors. In conc lusion, DNA histogram type was a valuable prognostic factor in univari ate analysis, and provided independent complementary information for p atients considered at low or intermediate risk by classical pathologic al findings. (C) 1995 Wiley-Liss, Inc.