Open AccessThe multivariate prognostic index and nuclear DNA content are independent prognostic factors in primary breast cancer patients
Author(s) -
Van Der Linden J. C.,
Lindeman J.,
Baak J. P. A.,
Meijer C. J. L. M.,
Herman C. J.
Publication year - 1989
Publication title -
cytometry
Language(s) - English
Resource type - Journals
eISSN - 1097-0320
pISSN - 0196-4763
DOI - 10.1002/cyto.990100110
Subject(s) - multivariate analysis , multivariate statistics , breast cancer , lymph node , proportional hazards model , oncology , medicine , mitotic index , prognostic variable , cancer , biology , nuclear dna , pathology , mitosis , statistics , gene , genetics , mathematics , mitochondrial dna
The predictive value of a previously described Multivariate Prognostic Index (which incorporates weighted values of the mitotic activity index, tumor size, and the axillary lymph node status), and the nuclear DNA content (DNA) was evaluated in 156 patients with primary invasive ductal breast cancer, diagnosed between 1980 and 1983. The results were analysed with respect to the occurrence of distant recurrence and survival of the patients after at least 3 yr of follow‐up (range 36–73 months; median 44 months). Known prognostic factors such as lymph node status, tumor size, and the mitotic activity index correlated independently with distant recurrence. Furthermore, in respect to survival, the investigated prognostic factors (except DNA content) were significantly correlated. The results indicate that the predictive value of the Multivariate Prognostic Index (MPI) is stronger ( P < 0.001) than of the nuclear DNA content ( P < 0.005) with respect to distant recurrence. In a Cox multivariate regression analysis DNA ploidy turned out to be an independent prognostic factor once the MPI was selected. Furthermore, in Cox's analysis, DNA ploidy was the fourth selected variable after lymph node status, mitotic activity index, and tumor size in individual parameter analysis. The results of this study indicate that, with respect to breast cancer screening programs, it seems worthwhile to integrate morphometric features, the MPI, and DNA ploidy in a new prognostic model.