PROGNOSTIC, QUANTITATIVE HISTOPATHOLOGIC VARIABLES IN LOBULAR CARCINOMA OF THE BREAST

Background. A retrospective investigation of 53 consecutively treated patients with operable lobular carcinoma of the breast, with a median follow-up of 6.6 years, was performed to examine the prognostic value of quantitative histopathologic parameters. Methods. The measurements were performed in routinely processed histologic sections using a simp le, unbiased technique for the estimation of the three-dimensional mea n nuclear volume (v(v)(nuc)BAR). In addition, quantitative estimates w ere obtained of the mitotic index (MI), the nuclear index (NI), the nu clear volume fraction (V(v)(nuc/tis)), and the mean nuclear profile ar ea (a(H)(nuc)BAR). Results. Estimates of v(v)(nuc)BAR, MI, NI, and V(v )(nuc/tis) were of significant or marginally significant prognostic va lue in univariate analyses, whereas no prognostic significance was att ributed to estimates of a(H)(nuc)BAR. In multivariate Cox analyses, th e clinical stage of disease, v(v)(nuc)BAR, MI, and NI were of signific ant independent, prognostic value. On the basis of the multivariate an alyses, a prognostic index with highly distinguishing capacity between prognostically poor and favorable cases was constructed. Conclusion. Quantitative histopathologic variables are of value for objective grad ing of malignancy in lobular carcinomas. The new parameter-estimates o f the mean nuclear volume-is highly reproducible and suitable for rout ine use. However, larger and prospective studies are needed to establi sh the true value of the quantitative histopathologic variables in the clinical management of patients with breast cancer.