The significance of quantitative biological cell parameters in the handling of mammary carcinoma

Recent work has shown that in breast cancer patients DNA measurements and estrogen receptor (ER)- analysis can contribute valuable information in the judgement of prognosis and choice of therapy. We report a case of advanced breast carcinoma with extensive liver metastases which clinically was regarded as beyond all therapeutic possibilities. Liver metastases were diagnosed first. Some time later a breast carcinoma was detected which was suggested to be the primary malignancy. Since high ER-values were demonstrated in the breast carcinoma, anti-estrogen therapy was given on trial. After three months the tumor mass in the liver had drastically diminished and today, more than 4 years after diagnosis, the patient is free from symptoms and doing excellently. A retrospective, microspectrophotometric DNA analysis in both the breast carcinoma and the liver metastasis showed DNA distribution patterns with nearly all the carcinoma cells exhibiting DNA values in the normal diploid region. This type of DNA profile has previously been shown to be correlated with good prognosis. We conclude that quantitative parameters such as DNA- and ER-content can give prognostic and therapeutic information over the above that furnished by clinical stage and morphological criteria.