Prognostic evaluation in node-positive breast carcinoma: stage versus growth rate

The range in survival time in operable node-positive breast carcinoma is considerable. Postoperative management is thus dependent on accurate prognostic assessment. This involves the choice of relevant prognostic factors. Theoretically these should include measurements of both stage and growth rate. In a series of 96 cases it is demonstrated that the diameter of the primary (3 cm and under/over 3 cm) can be used as a measure of tumour stage; the histological grade of the primary as one of tumour growth rate; and the presence/absence of tumour cells in the efferent nodal vessels (EVI status) as a measure of nodal stage. The latter is proposed as an alternative to the number of tumour-bearing nodes recovered from the axilla. Division of the cases on this basis was sufficient to assess high or low risk using routine histological methods.