Scattered fat invasion: An indicator for poor prognosis in premenopausal, and for positive estrogen receptor in postmenopausal breast cancer patients

Background: Intracrine mechanisms which accelerate cancer cell growth are b ecoming well known in breast cancer research. In this study, microscopic in vasive patterns of breast cancer cells into surrounding stromal tissues wer e evaluated. Patients and Methods: 174 patients (110 patients less than or equal to 50, and 64 greater than or equal to 60 years) underwent total or p artial mastectomy from 1985 to 1993, In these patients the microscopic inva sive pattern (especially scattered invasion into fat, SIF), influence on ho rmone receptor status, survival, and adjuvant therapy effectiveness were st udied. Results: A correlation was shown between being SIF- and estrogen rec eptor-positive only in older (greater than or equal to 60 years) patients ( chi (2) test, p = 0.058). In younger patients, SIF was also related to a po orer prognosis (log rank test, p = 0.0004). These results were also confirm ed by multivariate analysis. Adjuvant therapy activity was influenced by SI F status in premenopausal patients. Conclusion: In older patients, SIF may be related to an intracrine supply of estrogen. In younger patients, SIF se ems to work by a different mechanism for survival. These results also sugge st some influence of SIF on adjuvant chemo-endocrine therapy results. Copyr ight (C) 2000 S. Karger AG, Basel.