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A SIMPLE INDEX TO PREDICT PROGNOSIS INDEPENDENT OF AXILLARY NODE INFORMATION IN BREAST CANCER
Author(s) -
Seshadri Ram,
Horsfall David J.,
McCaul Kieran,
Leon Anthony SY.
Publication year - 1997
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1997.tb04576.x
Subject(s) - medicine , breast cancer , lymph node , oncology , multivariate analysis , stage (stratigraphy) , mammary gland , cancer , prognostic variable , pathology , paleontology , biology
Background : Since the course of breast cancer is often unpredictable, we wished to develop a model using characteristics of the primary tumour alone to predict prognosis. Methods : Several tumour features were determined, and after a median follow‐up duration of 65 months, multivariate analysis identified tumour size and grade, oestrogen receptor concentration, axillary lymph node metastasis and tumour cell proliferation fraction (MIB‐1 count) as being independently associated with increases in risk for both relapse and death from breast cancer. A prognostic model was constructed using tumour size and grade, oestrogen receptor concentration and MIB‐1 count only. A score of 1 for each was given to tumour size> 20 mm, tumour grade 2 or 3, oestrogen receptor concentration < 10 fmol/mg cytosol protein and MIB‐1 count < 9%. Five groups established by assigning a combined score of 0, 1, 2, 3 or 4 for each patient were analysed for their associations with disease‐free and overall survivals. Results : This preliminary model predicted 5‐year survival rates of 97, 91, 85, 68 and 50% for the five groups. The model was further simplified by excluding tumour grade from the analysis. The revised model identified four risk groups with predicted 5‐year survival rates of 91, 86, 66 and 52%. This model, the Adelaide prognostic index, was also able to identify four risk groups in both node‐negative and node‐positive patients. Conclusions : The Adelaide prognostic index can be used to predict prognosis even in the absence of axillary lymph node information.