FIBROTIC FOCUS IN INFILTRATING DUCTAL CARCINOMA OF THE BREAST - A SIGNIFICANT HISTOPATHOLOGICAL PROGNOSTIC PARAMETER FOR PREDICTING THE LONG-TERM SURVIVAL OF THE PATIENTS

The presence of fibratic fows (FF) in infiltrating ductal carcinoma (I DC) has been shown to be an important histological factor associated w ith high tumor aggressiveness, or early tumor recurrence or death. How ever, the clinicopathological significance of FF for predicting the lo ng-term survival of the patients with IDC has not been fully investiga ted. In order to elucidate this aspect, we divided 140 IDCs with at le ast 10 years of follow up into tumors with FF and those without. IDC w ith FF showed significantly higher histologic grade (P = 0.02), higher frequency of tumor necrosis (P = 0.02), higher frequency of cases wit h more than three positive lymph node metastases (P = 0.04), higher T classification (P = 0.009), and higher pathological stage (P = 0.0002) than those without FF Relative risk (RR) of tumor recurrence and deat h was significantly higher in tumors with FF than in those without (RR = 4.5, P < 0.00001 and RR = 5.6, P < 0.00001, respectively). In cases of early stage cancer (stages I, IIA, and IIB), or in those with less than four lymph node metastases, IDCs with FF demonstrated a signific antly higher risk than those without. Multivariate adjustments for oth er pathological factors did not change the RRs significantly. These re sults indicate that in long-term follow up the presence of FF is a sig nificant prognostic parameter for IDC, and therefore strongly suggest that IDCs must be divided into these with and without FF.