Cell-mediated immunity to tumor-associated antigens is a better predictor of survival in early stage breast cancer than stage, grade or lymph node status

Cell-mediated immune (CMI) responses to tumor-associated antigens (TAA) in the early postoperative period were examined for correlations with disease recurrence and survival in a 13-year-prospective study of 77 stage 1 and 2 breast cancer patients treated with modified radical or radical mastectomy alone. Among the 21 patients who had positive lymphoproliferative tests usi ng patients' peripheral blood mononuclear cells and autologous TAA of breas t cancer cells, only one died from metastatic disease (5%). Among the 56 pa tients who had a negative test, 23 died from metastatic disease (41%). This difference is statistically significant (p = 0.002) Three other risk facto rs including tumor size, nodal status and cell differentiation patterns wer e also analyzed. When these three clinical-pathologic criteria were analyze d individually, none reliably predicted disease recurrence and survival. No dal status was the most predictive clinical-pathologic risk factor, but was not significant (p = 0.089). The results of this study demonstrate the det ection of CMI responses against autologous TAA by lymphoproliferative assay s identifies a sub-set of stage 1 and 2 breast cancer patients who are at m inimal risk of developing metastatic disease. This testing also identifies immunologically unreactive patients who are at risk for disease recurrence.