EVALUATION OF RESIDUAL CELLULARITY AND PROLIFERATION ON PREOPERATIVELY TREATED BREAST-CANCER - A COMPARISON BETWEEN IMAGE-ANALYSIS AND LIGHT-MICROSCOPY ANALYSIS

Histopathology has been suggested as a reliable method for tumour redu ction evaluation of preoperatively treated breast cancer. Immunocytoch emistry can be used to enhance the visibility of residual tumour cellu larity and in the evaluation of its proliferative activity. We compare d Image Analysis (IA) with Light Microscopy Analysis (LMA) on sections of breast carcinomas treated with preoperative chemo-or chemo/radioth erapy in the evaluation of the Neoplastic Cell Density (NCD) (69 cases ) and the Proliferation Index (PI) (35 cases). NCD was expressed as th e immunoreactive area to cytokeratin over the total original neoplasti c area and PI was expressed as the number of immunostained tumoural nu clei with MIB 1 MoAb over the total of tumoural nuclei. The intraobser ver agreement and that between IA and LMA for both indices were estima ted by the common (kappa(W)) and the jackknife weighted kappa statisti c (<(kappa)over tilde> (W)). The extent of agreement of each considere d category was also assessed by means of the category-specific kappa s tatistics (kappa(CS)). The intraobserver agreement within LMA for NCD and PI and that between IA and LMA for PI were both satisfactory. Upon evaluation of the NCD, the agreement between IA acid LMA showed unsat isfactory results, especially when the ratio between the residual tumo ur cells and the background was critical.