Breast Cancer Research and Treatment

, Volume 91, Issue 1, pp 61–71

Combined flow cytometry determination of S-phase fraction and DNA ploidy is an independent prognostic factor in node-negative invasive breast carcinoma: analysis of a series of 271 patients with stage I and II breast cancer

  • L. Moureau-Zabotto
  • C. Bouchet
  • D. Cesari
  • S. Uzan
  • J.-P. Lefranc
  • M. Antoine
  • C. Genestie
  • E. Deniaud-Alexandre
  • J.-F. Bernaudin
  • E. Touboul
  • J. Fleury-Feith
Report

DOI: 10.1007/s10549-004-7047-1

Cite this article as:
Moureau-Zabotto, L., Bouchet, C., Cesari, D. et al. Breast Cancer Res Treat (2005) 91: 61. doi:10.1007/s10549-004-7047-1

Abstract

Purpose. To assess the significance of S-phase fraction (SPF) and DNA ploidy evaluated by DNA flow cytometry as prognostic markers in stage I or II breast cancer.

Patients and methods. A series of 271 patients, treated by surgery, radiotherapy ± systemic therapy was analyzed (median follow up: 64 months). Standardized flow cytometry cell preparation from frozen samples and consensus rules for data interpretation were followed. Three SPF classes were defined on the basis of tertiles after adjustment for ploidy. Four groups were defined based on combinations of DNA ploidy (DIP: diploid; ANEUP: aneuploid) and SPF: DIP and low SPF (DL, n=37), DIP and medium or high SPF (DMH, n=76), ANEUP and low SPF (AL, n=24), ANEUP and medium or high SPF (AMH, n=68). Local control rate (LCR), disease-free survival (DFS), metastasis-free survival (MFS), and overall survival (OS) were correlated with DNA ploidy, SPF, DL to AMH groups, T and N stages, SBR grading, age, and hormonal status on univariate and multivariate analysis (Cox model).

Results. On univariate analysis, DFS and LCR were higher for DIP tumours. High SPF values were associated with shorter DFS. LCR, MFS, DFS, and OS rates were significantly different with an increasingly poorer prognosis from DL to AMH. On multivariate analysis, groups DL to AMH, histological node involvement and T stage were independently associated with MFS, and DFS. In N(−) patients, DL to AMH remained independent for MFS and DFS. For SBR III tumours, MFS and OS were significantly different in DL to AMH groups. These results strongly support the use of combined evaluation of DNA ploidy and SPF as independent parameters in clinical trials for N(−) stage I and II breast cancer.

Keywords

breast cancer DNA ploidy S-phase fraction 

Abbreviations

AL

aneuploid tumours with low SPF values

AMH

aneuploid tumours with intermediate or high SPF values

DL

diploid tumours with low SPF values

DMH

diploid tumours with intermediate or high SPF values

Copyright information

© Springer 2005

Authors and Affiliations

  • L. Moureau-Zabotto
    • 1
    • 7
  • C. Bouchet
    • 2
  • D. Cesari
    • 2
  • S. Uzan
    • 3
  • J.-P. Lefranc
    • 5
  • M. Antoine
    • 4
  • C. Genestie
    • 6
  • E. Deniaud-Alexandre
    • 1
  • J.-F. Bernaudin
    • 2
  • E. Touboul
    • 1
  • J. Fleury-Feith
    • 2
  1. 1.Department of Radiation therapyInstitut Paoli CalmettesMarseilleFrance
  2. 2.Service d’Histologie-Biologie tumoraleUniversité ParisFrance
  3. 3.Service de Gynécologie ObstétriqueFrance
  4. 4.Service d’Anatomie-pathologiqueHôpital TenonParis
  5. 5.Service de Chirurgie Gynécologique et MammaireFrance
  6. 6.Service d’Anatomie-pathologiqueHôpital La Pitié SalpétrièreParisFrance
  7. 7.Service d’Oncologie Radiothérapie

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