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Prediction of outcome after first recurrence of breast cancer
S Aaltomaa1, P Lipponen, M Eskelinen
1Department of Surgery, Kuopio University Hospital, Finland.
Objective:
To assess the independent power of certain clinical, histological, and morphometric variables to predict survival after first recurrence of breast cancer.
Design:
Long term follow up study.
Setting:
Departments of surgery and pathology, University Hospital.
Subjects:
212 patients (from a consecutive series of 517) who developed recurrence after primary treatment of breast cancer between 1968 and 1990.
Interventions:
Re-examination of histology of primary tumours, follow up of patients, and calculation of predictive score by Cox's regression analysis.
Results:
The nodal status at the time of diagnosis (p less than 0.001), the SD of the nuclear area (p = 0.01), the degree of tubule formation (p = 0.003), and the age of patient, were all independent predictors. The most important predictor of survival was the prognostic score derived from the coefficients of the Cox's model (p less than 0.0001).
Conclusion:
Survival after first recurrence can be accurately predicted by advanced histological analysis of the primary tumour tissue. Combination of independent predictors permits even more accurate estimation of survival time.