Breast Cancer Research and Treatment

, Volume 12, Issue 2, pp 191–204

Proliferative index of breast carcinoma by thymidine labeling: Prognostic power independent of stage, estrogen and progesterone receptors

  • John Strauch Meyer
  • Michael Province

DOI: 10.1007/BF01805940

Cite this article as:
Meyer, J.S. & Province, M. Breast Cancer Res Tr (1988) 12: 191. doi:10.1007/BF01805940


We studied cellular proliferation by measuring the tritiated thymidine labeling index (TLI) in slices of primary invasive breast carcinomas. Estrogen receptor (ER) and progesterone receptor (PgR) were measured by ligand-binding assay.

The TLI was a strong independent predictor of survival and relapse-free survival in women with or without axillary lymph nodal metastases and in American Joint Committee stage I. In operable node-negative women treated surgically, predicted survival at 5 years was 89 ± 4% (probability±standard error) for 81 patients with low TLI (⩽3%), 64 ± 7% for 101 with mid TLI (3.1 – 8%), and 66 ± 6% for 86 with high TLI (>8%) (P = 0.001). Probabilities of survival for patients with positive axillary nodes were 79 ± 6% for 86 with low, 71 ± 7% for 71 with mid, and 52 ± 6% for 89 with high TLI (P = 0.0002). In stage I patients (tumor diameter not exceeding 2 cm), 5-year survival probabilities were 93 ± 4% in 70 with low, 72 ± 8% in 43 with mid, and 58 ± 10% in 35 with high TLI, (P = 0.0005). The TLI was predictive for survival and relapse-free survival within subgroups positive and negative for ER and positive for PgR (P<0.05) in stage I patients, and a predictive trend was observed in the PgR-negative subgroup (P = 0.16). TLI also predicted within different categories of vascular invasion and nuclear grade.

A stepwise Cox proportional hazards model selected TLI, number of positive axillary lymph nodes, and maximum diameter of the breast carcinoma as independent variables predictive of relapse, and added ER as a fourth variable for prediction of survival.

Key words

breast cancer cell kinetics estrogen receptor progesterone receptor prognosis proliferative index stage thymidine labeling index 

Copyright information

© Kluwer Academic Publishers 1988

Authors and Affiliations

  • John Strauch Meyer
    • 1
    • 3
  • Michael Province
    • 2
  1. 1.Department of PathologyWashington University School of Medicine, St. Louis, Mo., St. Luke's HospitalChesterfieldUSA
  2. 2.Division of BiostatisticsWashington University School of MedicineSt. LouisUSA
  3. 3.The Jewish Hospital of St. LouisUSA

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