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New prognostic factors associated with long-term survival in node-negative breast cancer patients

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Abstract

Background

This study was undertaken to determine the absolute and relative value of angiogenesis, proliferating cell nuclear antigen (PCNA) and conventional prognostic factors in predicting relapse-free survival (RFS) and overall survival (OS) rates associated with long-term survival in Japanese patients with node-negative breast cancer.

Patients and Methods

Two hundred patients with histological node-negative breast cancer were studied. We investigated nine clinicopathological factors, including angiogenesis, PCNA using permanent-section immunohistochemistry, clinical tumor size, histological grade (HG), tumor necrosis, lymphatic vessel invasion (LVI), histological extension, histological classification, and infiltrating growth (INF), followed for a median of 10 years (range, 1 to 20).

Results

Twenty-one patients (10.5%) had recurrence and 15 patients (7.5%) died of breast cancer. Univariate analysis showed that PCNA, clinical tumor size, HG, angiogenesis, and LVI were significantly predictive of 20-year RFS or OS. Tumor necrosis was significantly predictive of OS, not of RFS. Multivariate analysis showed that clinical tumor size (P=0.0003), angiogenesis (P=0.0003), PCNA (P= 0.0064), and HG (P=0.0401) were significant independent prognostic factors for RFS. PCNA (P< 0.0001) and clinical tumor size (P=0.0112) were significant independent prognostic factors for OS, while angiogenesis was a borderline significant factor.

Conclusion

PCNA and angiogenesis were important new prognostic factors in node-negative breast cancer patients.

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Abbreviations

PCNA:

Proliferating cell nuclear antigen

RFS:

Relapse-free survival

OS:

Overall survival

HG:

Histological grade

LVI:

Lymphatic vessel invasion

INF:

Infiltrating growth

AMC:

Average microvessel count

RR:

Relative risk

HMC:

Highest microvessel count

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Authors and Affiliations

  1. Surgery II, Tokyo

    Takao Kato, Tsunehito Kimura, Nobue Takami, Ryuhei Miyakawa, Schinichi Tanaka, Hiroshi Muraki, Takako Kamio, Akiho Fujii, Kazuko Yamamoto & Shingo Kameoka

  2. Surgical Pathology, Tokyo

    Toshio Nishikawa

  3. Pathology, School of Medicine, Tokyo Women’s Medical University, Tokyo

    Takeshi Kasajima

Authors
  1. Takao Kato
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  2. Tsunehito Kimura
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  3. Nobue Takami
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  4. Ryuhei Miyakawa
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  6. Hiroshi Muraki
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  7. Takako Kamio
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  11. Toshio Nishikawa
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  12. Takeshi Kasajima
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Kato, T., Kimura, T., Takami, N. et al. New prognostic factors associated with long-term survival in node-negative breast cancer patients. Breast Cancer 6, 370–377 (1999). https://doi.org/10.1007/BF02966456

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