Image cytometry detection of breast cancer cells with > 5C DNA content andminor DNA stemlines

OBJECTIVE: To determine if the presence of cells having a DNA content > 5c and occurring at very low frequency is related to breast cancer outcome. STUDY DESIGN: Feulgen-stained imprints of fresh tumors used for routine sta ndard DNA image cytometry were reanalyzed, with the aim of detecting hyperp loid (>5c) cells or minor stemlines. Specially adapted soft-ware was used. RESULTS: The new DNA analysis showed discordance of 47.3% with standard DNA cytometry. Minor stemline or rarely occurring 5e exceeding cells were foun d. These were not detected by the first DNA analysis. The presence of both DNA hyperploid cells occurring as rare events and a DNA hyperploid stemline was related to outcome. CONCLUSION: The detection of DNA hyperploid cells, even in very small numbe rs, appears essential to outcome, particularly in diploid or single DNA ane uploid breast cancers.