[Evaluation of nuclear morphometric risk grade as a prognostic factor of early breast cancer]

The prognostic significance of nuclear areas was studied in 241 patients with primary stage I or II breast cancer. The mean follow-up period was 56.4 months. The nuclear areas of 100 breast cancer cells in HE stained specimen in each patient were measured by means of an image analyzing system, and the mean nuclear area (MNA) and standard deviation of nuclear area (SDNA) were calculated. MNA and SDNA were significantly larger in patients with recurrence than without it. Patients were divided into 2 groups according to the Nuclear Morphometric Risk Grade (NMRG), which was defined as follows: high risk: MNA > or = 80 microns 2 and SDNA > or = 28 microns 2; low risk: MNA < 80 microns 2 or SDNA < 28 microns 2. High risk patients revealed significantly poor disease free and overall survival than low risk patients (p < 0.0001, p < 0.0001). Furthermore, NMRG was a significant prognostic factor in node-negative patients. Cox multivariate analysis showed that nodal status and NMRG were independent predictors of tumor recurrence (n:p = 0.001; NMRG:p = 0.27) and survival (n:p < 0.001; in the NMRG:p = 0.0007). NMRG was a strong prognostic factor in patients in the early stage and it might support the decision for or against adjuvant therapy.