Breast Cancer Research and Treatment

, Volume 21, Issue 3, pp 193–199 | Cite as

Prognostic significance of the immunohistochemical reaction to human milk fat globule antibodies in node-negative and node-positive breast cancer

  • Ernest E. Sterns
  • William A. Fletcher
  • Benny Zee


The status of axillary lymph nodes in patients with breast cancer is important prognostically but does not identify all patients who will have long or short survival. To determine if the immunohistochemical reaction of tumor cells to human milk fat globule (HMFG) antibodies will define prognosis more specifically, we examined patients with node-negative disease and patients with more than three positive nodes, the extremes of the prognostic spectrum. In both node-negative and node-positive groups, patients who relapsed were matched by age at diagnosis, tumor size, histologic type, and receptor status, with patients who remained disease-free for a minimum of 48 months. Patients with poor survival had a higher proportion of poorly differentiated cancers. The ability to generate antigens recognized by HMFG antibodies was decreased in patients with recurrent disease, but this was significant only in patients with node-positive tumors. Tumors of patients who remained disease-free were more likely to have a pattern of membrane staining, while cytoplasmic staining was more frequent in those who relapsed. The results suggest that immunohistologic response to HMFG antibodies may assist in identifying cancers with poor prognosis, supplementing the prediction derived from node status.

Key words

breast cancer human milk fat globule antibodies immunohistochemistry prognosis 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Fisher ER, Sass R, Fisher B: Pathologic findings from the National Surgical Adjuvant Project for breast cancers (protocol No. 4): X Discriminants for tenth year treatment failure. Cancer 53: 712–723, 1984PubMedGoogle Scholar
  2. 2.
    Shi Z-R, Itzkowitz SH, Kim YS: A comparison of three immuno-peroxidase techniques for antigen detection in colorectal carcinoma tissue. J Histochem Cytochem 36: 317–322, 1988PubMedGoogle Scholar
  3. 3.
    Sterns EE, Fletcher WA: Bilateral cancer of the breast: A review of clinical, histologic, and immunohistologic characteristics. Surgery 110: 617–622, 1991PubMedGoogle Scholar
  4. 4.
    Sterns EE, Cochran AJ: Monoclonal antibodies in the diagnosis and treatment of carcinoma of the breast. Surg Gynecol Obstet 169: 81–98, 1989PubMedGoogle Scholar
  5. 5.
    Bloom GJG, Richardson WW: Histological grading and prognosis in breast carcinoma. Br J Cancer 11: 359–377, 1957PubMedGoogle Scholar
  6. 6.
    Fleiss J, Levin B: Sample size determination in studies with matched pairs. J Clin Epidemiol 41: 727–730, 1988CrossRefPubMedGoogle Scholar
  7. 7.
    Early Breast Cancer Trialists' Collaborative Group: Effects of adjuvant tamoxifen and cytotoxic therapy on mortality in early breast cancer. An overview of 61 randomized trials among 28,896 women. N Engl J Med 319: 1681–1692, 1988Google Scholar
  8. 8.
    Rosner D, Lane WW, Nemoto T: Predicting disease-free survival in node-negative breast cancer patients: Do they need adjuvant therapy? Proc Am Assoc Cancer Res 30: A1008, 1989Google Scholar
  9. 9.
    Davis BW, Gelber RD, Goldhirsch A, Hartmann WH, Locher GW, Reed R, Golouch R, Save-Soderbergh J, Holloway L, Russell I, Rudenstam CM: Prognostic significance of tumor grade in clinical trials of adjuvant therapy for breast cancer with axillary lymph node metastasis. Cancer 58: 2662–2670, 1986PubMedGoogle Scholar
  10. 10.
    Rosen PP, Kinne DW, Lesser M, Hellman S: Are prognostic factors for local control of breast cancer treated by primary radiotherapy significant for patients treated by mastectomy? Cancer 57: 1415–1420, 1986PubMedGoogle Scholar
  11. 11.
    Andersen JA, Fischermann K, Hou-Jensen K, Henriksen E, Andersen KW, Johansen H, Brincker H, Mouridsen HT, Castberg Th, Rossing N, Rorth M: Selection of high risk groups among prognostically favorable patients with breast cancer: An analysis of the value of prospective grading of tumor anaplasia in 1048 patients. Ann Surg 194: 1–3, 1981PubMedGoogle Scholar
  12. 12.
    Joensuu H, Toikkanen S, Klemi PJ: DNA index and S-phase fraction and their combination as prognostic factors in operable ductal breast carcinoma. Cancer 66: 331–340, 1990PubMedGoogle Scholar
  13. 13.
    Wright C, Angus B, Nicholson S, Sainsbury JR, Cairns, J, Gullick WL, Kelly P, Harris AL, Horne CH: Expression of c-erbB-2 oncoprotein: A prognostic indicator in human breast cancer. Cancer Res 49: 2087–2090, 1989PubMedGoogle Scholar
  14. 14.
    Taylor-Papadimitriou J, Millis R, Burchell J, Nash R, Pang L, Gilber J: Patterns of reaction of monoclonal antibodies HMFG-1 and -2 with benign breast tissue and breast carcinomas. J Exper Pathol 2: 247–260, 1986Google Scholar
  15. 15.
    Berry N, Jones DB, Smallwood J: The prognostic value of the monoclonal antibodies HMFG-1 and HMFG-2 in breast cancer. Br J Cancer 51: 179–186, 1985PubMedGoogle Scholar
  16. 16.
    Heyderman E, Steele K, Ormerod MG: A new antigen on the epithelial membrane: its immunoperoxidase localisation in normal and neoplastic disease. J Clin Pathol 32: 35–39, 1979PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1992

Authors and Affiliations

  • Ernest E. Sterns
    • 1
  • William A. Fletcher
    • 1
  • Benny Zee
    • 2
    • 1
  1. 1.From the Departments of Surgery and PathologyQueen's University and the Kingston General HospitalKingstonCanada
  2. 2.Clinical Trials UnitNational Cancer Institute of CanadaCanada

Personalised recommendations