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Breast cancer is the second leading cause of death by cancer in women inthe United States. The occurrence of high numbers of macrophages in the tumorstroma has been associated with tumor progression and poor prognosis in breastand other solid malignancies. However, macrophage numbers in tumors have not beenvalidated as a prognostic factor in clinical practice. The present analysis wasdesigned as a pilot study aimed at determining whether the presence of CD68+ macrophagesis an independent prognostic factor in small T1 estrogen receptor (ER)+ breastcancers across three different ethnic groups, i.e. African-American, Latina andCaucasian women. A retrospective pilot analysis of 30 T1 breast cancer cases encompassingthese three ethnic groups was carried out. African-American and Latina women presentwith less incidence but more aggressive breast cancer disease and, therefore,proportionally higher death rates. Using immuno-histochemistry, we sought to identifywhether there was any association between the presence and density of CD68+ macrophagesand standard prognostic markers with overall survival in these groups. Our datarevealed that overall survival did not differ significantly for the occurrenceor density of CD68+ macrophages in T1 ER+ tumors. There were also no significantdifferences in overall survival for the occurrence of CD68+ macrophages acrossethnicities, although macrophage numbers were significantly higher in tumors fromAfrican-American and Latina than in Caucasian patients. Importantly, but not surprisingly,the absence of the progesterone receptor was associated very strongly with decreasedoverall survival. This pilot project shows that CD68+ macrophages are not pivotalin determining tumor prognosis in early T1 breast cancers. New studies are presentlybeing conducted to assess the value of different macrophage markers and macrophageactivation profiles as prognostic factors in breast cancers of different clinicalstages, using a larger number of patients among these three different ethnicities.

Macrophages as independent prognostic factors in small T1 breast cancers