Nuclear volume and breast cancer prognosis

Background: In breast cancel; nuclear volume estimates can be expected to b e better prognosticators than nuclear profile areas because biological vari ation is wider in volume estimates than in area measurements. Materials and Methods: 191 invasive breast cancel samples were available for nuclear vol ume measurements. To estimate the volume weighted mean nuclear volume, poin t-sampled linear intercepts were used on micrographs. The nuclear profile a rea was measured from 148 cases matching volume measurements and run by the Prodit morphometry program. Measurements were compared as prognosticators after a follow-up of 5 years. A computerized method on a randomly selected large number of nuclei was also applied in 17 cases. Bcl-2 immunostaining w as compared with nuclear measurements. Results: The correlation of volume a nd area measurements was statistically significant, but the correlation coe fficients were low. The nuclear area showed a significant difference in sur vival at the 75 percentile cut-point but the volume-weighted mean nuclear v olume did not allow distinction of different prognostic groups. Computerize d volume measurements based on a large number of nuclei and measurements ba sed on the simpler method did not show statistically significant correlatio n. Bcl-2 staining did not show any correlation with volume or area measurem ents. Conclusions: Although the prognostic value of nuclear area was shown in our study, the volume-weighted mean nuclear volume did not show prognost ic significance. Improvement of the methodology which could decrease method variation and increase reproducibility of measurements is urgent for verif ication of the prognostic value of nuclear volume measurements. Bcl-2 immun ostaining and nuclear area measurements were independent prognostic variabl es.