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Åke Borg

Åke Borg

Principal investigator

Åke Borg

Indicators of prognosis in node-negative breast cancer

Author

  • H Sigurdsson
  • Bo Baldetorp
  • Åke Borg
  • M Dalberg
  • Mårten Fernö
  • Dick Killander
  • Håkan Olsson

Summary, in English

Measures of the proliferative activity of tumor cells have prognostic value in patients with node-negative breast cancer. We studied 367 women in southern Sweden who had undergone surgical resection for such cancer. Tumor specimens were analyzed with DNA flow cytometry in order to estimate both the DNA content (ploidy) and the fraction of cells in the synthetic phase of the cell cycle (S phase). The median duration of follow-up was four years; 28 percent of the patients received adjuvant therapy, usually with tamoxifen (n = 83). A multivariate analysis based on complete data on 250 patients included the following covariates: age (greater than or equal to 75, 50 to 74, and less than or equal to 49 years), tumor size (less than or equal to 20 vs. greater than 20 mm), concentration of estrogen and progesterone receptors (less than 10 vs. greater than or equal to 10 fmol per milligram of protein), ploidy (diploid vs. nondiploid), and S-phase category (fraction of cells in S phase: less than 7.0 percent, 7.0 to 11.9 percent, and greater than or equal to 12 percent). The S-phase fraction yielded the most prognostic information, followed by progesterone-receptor status and tumor size. A prognostic model based on these three variables identified 37 percent of the patients as constituting a high-risk group with a fourfold increased risk of distant recurrence. In the remaining 63 percent of the patients, the five-year overall survival rate (92 +/- 4 [+/- SE] percent) did not differ from the expected age-adjusted rate for Swedish women. We conclude that a prognostic index that includes indicators of the proliferative activity of tumor cells may be able to identify women with node-negative breast cancer in whom the risk of recurrence is sufficiently low that adjuvant chemotherapy can be avoided.

Department/s

  • Breastcancer-genetics
  • Personalized Breast Cancer Treatment

Publishing year

1990

Language

English

Pages

1045-1053

Publication/Series

New England Journal of Medicine

Volume

322

Issue

15

Document type

Journal article

Publisher

Massachusetts Medical Society

Topic

  • Cancer and Oncology

Status

Published

Research group

  • Personalized Breast Cancer Treatment

ISBN/ISSN/Other

  • ISSN: 0028-4793