Quantitative aspects in defining prognostic factors of breast cancer

Although many attempts have been made to define prognostic criteria, the long-term prediction of breast cancer prognosis remains a difficult task. In search of morphologic criteria with prognostic significance, we investigated 101 ductal invasive breast carcinomas by means of computerized image analysis. Our purpose was to define prognostic measures of the basic characteristics of breast cancers, growth rate and metastatic potential. Consequently, three principal types of analysis were performed: on Feulgen stained nuclei, on histological structures by using differential stainings and on desmosome-complexes revealed by immunofluorescence microscopy. The data obtained from analysis of the cell nuclei morphology and the chromatin structure served to establish objective nuclear grading. In comparison to the visual grading made during routine histology, the objective grading correlates better with the existence of lymph node metastases and with receptor status. The description of desmosome-complexes by using quantitative immunofluorescence microscopy indicates that in order to obtain relevant results, the histological pattern of the tumors has to be considered. In order to characterize these structures we introduced special methods of cluster analysis. The studies are an example of complex quantitative analysis of tumor morphology performed with different combined methods of microscopy and image processing.