Cell-mediated immune responses--prognostic indicators of survival from breast cancer

The prognostic significance of cell-mediated immunity measured by a single post-operative in vitro lympho-proliferation assay with an autologous tumor hypotonic membrane preparation (HMP) and in the mixed leukocyte culture (MLC) is shown in white and black breast cancer patients followed for as long as 14 years. Nine of 16 white patients and 6 of 11 black patients who did not respond to their tumor but who had a normal MLC died of systemic breast cancer as compared to 1 of 20 white and 2 of 5 black patients who responded to the HMP and/or had a depressed MLC. When high-risk clinical variables (nodal status, tumor size and cell differentiation) were combined with high-risk immunological risk factors in white patients, the prognostic values of both the immunological and clinical categories were enhanced. Seven of 9 concordant high-risk white patients died from systemic breast cancer. These results point to the necessity of immunological testing as an aid in clinical staging of breast cancer patients.