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Objective: The main purpose of this research was to determine the prognostic relevance of tumour infiltrating lymphocytes (TILs), CD4+ and CD8+ lymphocytes in patients with breast cancer. Methods: Tissue samples were obtained from 120 breast cancer patients with operable disease and ductal histology. The intensity of lymphocyte infiltrate (LI) was graded from 0 to 3 semi-quantitatively on H&E stained whole sections. CD4+ and CD8+ T lymphocytes were evaluated in the tumor samples using monoclonal antibodies. Results: A positive correlation between the level of TILs, as well as CD4+ lymphocytes and the size of the tumor, the presence of metastases in the axillary lymph nodes, histological grade, stadium and relapse of the disease was determined. High LI and high expression of CD4+ lymphocytes was seen in triple negative and HER2 positive tumors. A positive correlation between the level of CD8+ lymphocytes and histological grade, and positive HER2 expression was also found. A inverse correlation between the level of TILs, CD4+ and CD8+ lymphocytes and the presence of estrogen and progesterone receptors as well as the patients’ age was detected. The patients with the higher level of TILs and CD4+ lymphocytes had distinctly worse disease free survival (DFS). Conclusion: This research may contribute to development of the breast carcinoma “immunologic grade” which would reflect the intensity of the immune response of each individual patient and which would impact the prognosis of the disease, together with the other standard prognostic parameters.

Clinical Relevance of Determination of Tumour Infiltrating Lymphocytes in Breast Carcinoma