Importance of complete histopathology report in predicting prognosis in breast cancer

Tumour size, nuclear grade, mitotic activity, lymph node status, lymphatic and vascular invasion are some of the simple histological parameters associated with breast cancer prognosis. These parameters can be appreciated on routine light microscopy. Each of these parameters are associated with breast cancer aggressiveness. A total of 42 female patients over a period of 10 years, with pure infiltrating duct carcinoma stage II were considered. These 42 patients included 23 short-term survivors (survival less than 3 years) and 19 long-term survivors (survival more than 7 years). The histology slides of these patients were reviewed without the knowledge of survival status. Though all these patients were stage II and had received similar treatment, there was a difference in survival. The survival difference was because of the difference in the aggressiveness of the tumour. It was found that the statistically significance correlates with survival in order of importance were tumour grade (p = 0.02), lymphatic-vascular invasion (p = 0.02), number of positive lymph nodes (p = 0.02), mitotic activity (p = 0.03), nuclear pleomorphism (p = 0.04) and Nottingham score (p = 0.04). We found no correlation of survival with tumour necrosis, tumour size, and architecture. We believe that a complete histology report that includes all the above parameters will help in predicting prognosis of patients. It could also help in designing better treatment protocols for individual patients.