Tumor Biology

, Volume 33, Issue 5, pp 1573–1580 | Cite as

The prognostic significance of tumor-associated stroma in invasive breast carcinoma

  • Soomin Ahn
  • Junhun Cho
  • Jiyoun Sung
  • Jeong Eon Lee
  • Seok Jin Nam
  • Kyoung-Mee Kim
  • Eun Yoon Cho
Research Article


Fibroblasts in the stromal component of a tumor may influence tumor progression in various organs. The prognostic significance of tumor-infiltrating lymphocytes is also frequently reported. However, the prognostic significance of the stromal component in breast cancers, particularly those of high grade, has not been established. In this study, we analyzed surgically resected specimens from 545 patients with breast carcinoma, including 193 high-grade tumors, for tumor–stroma ratio, dominant stroma type [collagen (C), fibroblast (F), or lymphocyte (L) dominant type], and central fibrosis on hematoxylin–eosin-stained histological sections. We correlated these features with clinical prognosis. Among the 533 specimens examined, 127 (23.3 %) were of C type, 292 (53.6 %) of F type, and 114 (20.9 %) of L type. Central fibrosis was found in 99 tumors (18 %). The dominant stroma type was a significant prognostic factor on univariate and multivariate analyses, together with T classification, nodal status, and Bloom–Richardson grade. Tumor–stroma ratio and central fibrosis did not predict survival on multivariate analysis. Even in high-grade tumors, relapse-free intervals differed significantly according to dominant stroma type. Thus, conventional hematoxylin–eosin-stained tumor slides may contain more prognostic information than previously thought; in particular, the dominant stroma type in invasive breast cancer may potentially be used to predict outcome.


Invasive breast cancer Tumor stroma Disease-free survival Multivariate analysis 



Disease-free survival


Estrogen receptor


Progesterone receptor


Disease-free interval


Overall survival



This study was supported by a Samsung Biomedical Research Institute grant, #SBRI C-B0-319-2.


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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2012

Authors and Affiliations

  • Soomin Ahn
    • 1
  • Junhun Cho
    • 1
  • Jiyoun Sung
    • 1
  • Jeong Eon Lee
    • 2
  • Seok Jin Nam
    • 2
  • Kyoung-Mee Kim
    • 1
  • Eun Yoon Cho
    • 1
  1. 1.Department of Pathology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  2. 2.Department of Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea

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