Mathematical Pathological Approach as a Novel Tool for Prognosis in Breast Cancer

Breast cancer is the leading cause of cancer in women worldwide. The novel mathematical pathology approach was founded to identify important patient-specific predictors of tumor growth to improve the accuracy of intervention and prognosis. Diffusion penetration length, a model-derived mathematical function, measures how far chemotherapeutic agents diffuse through the tumor tissue. The present study evaluated the diffusion penetration length in patients of invasive ductal carcinoma and its correlation with histopathological type, grade, stage, and surrogate molecular classification. Routine histopathological processing followed by hematoxylin and eosin staining and immunohistochemistry for ER, PR, Her2neu, Ki67, and cleaved caspase-3. Each case was evaluated for histological type, grade, stage, and surrogate molecular classification. The proliferative and apoptotic index were calculated manually by hotspot counting. Mammographic measurements of tumor dimensions were performed by reviewing the images and the geometric mean was calculated. The above values were used to calculate diffusion penetration length in the mathematical working model. The diffusion penetration length was higher in Grade III than in Grade II. However, it was not statistically significant. The correlation of diffusion penetration length with pathological tumor size, nodal involvement, and the stage was found to be statistically insignificant. However, a significant correlation could be established between diffusion penetration length and surrogate molecular classification. Although diffusion penetration length could not be established as an independent prognostic parameter, its evaluation in infiltrating ductal carcinoma of breast may be of great utility.