PREMENOPAUSAL NODE-NEGATIVE BREAST-CANCER - MAY ADJUVANT CHEMOTHERAPYBE INDICATED BY THE ANALYSIS OF NUCLEAR-DNA DYNAMICS

The management of premenopausal node-negative breast cancer patients i s discussed controversially. Accurate cellular as well as biochemical markers are essential for this cancer group to identify high risk pati ents needing adjuvant chemotherapy. In the present study, flow cytomet ric DNA analysis (DNA-ploidy status, DNA-index, S-phase fraction, S+(G (2)+M)-phase fraction) and clinico-pathological variables (clinical st age, tumor size, receptor status, age, histological type and grade) as prognostic factors were determined on paraffin-embedded tumors to pre dict overall survival (OS) and disease-free survival (DFS). Median obs ervation time was 6.1 years (n = 57). S+(G(2)+M)-phase fraction was th e only flow cytometric DNA predictor of overall survival in the univar iate analysis (log-rank test): As compared to the patients with lower S+(G(2)+M)-phase fraction (less than or equal to 9.3%), patients with S+(G(2)+M)-phase fraction greater than 9.3% had shorter survival (P = 0.039). Of all the clinico-pathological parameters analyzed (univariat e analysis), the survival time was found to be longer when estrogen- a nd/or progesterone-receptor status was positive (overall survival: P = 0.039; disease-free survival: P = 0.017) and the histological grade w as low (overall survival: I + II vs III: P = 0.024; I vs II vs III: P = 0.046). In the multivariate analysis, receptor status was the strong est predictor for overall and disease-free survival. These results sug gest that S+(G(2)+M)-phase fraction in premenopausal node-negative bre ast cancer could be an additional valuable prognostic factor to classi fy high risk breast cancer patients needing adjuvant chemotherapy.