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Mitotic frequency as a prognostic factor in breast cancer
S Biesterfeld1, I Noll, E Noll
1Institute of Pathology, Technical University of Aachen, Germany.
Human Pathology
|January 1, 1995
Summary
Mitotic figure counting in breast cancer provides crucial prognostic information, outperforming traditional methods like TNM staging and DNA cytometry for predicting patient survival outcomes.
Area of Science:
- Oncology
- Pathology
- Biostatistics
Background:
- Accurate grading of breast cancer malignancy is essential for patient prognosis and TNM staging.
- Current grading methods may lack sufficient prognostic validity and reproducibility.
Purpose of the Study:
- To evaluate the prognostic validity and reproducibility of mitotic figure counting in breast cancer.
- To compare mitotic figure counting with TNM staging, Bloom and Richardson grading, DNA cytometry, and morphometry.
Main Methods:
- Analysis of 104 breast cancer patient cases using routine hematoxylin-eosin stained slides.
- Mitotic figures were counted in high power fields (HPFs) at 400X magnification.
- Univariate survival analysis and Cox stepwise regression were employed.
Main Results:
- Mitotic figure counting identified three patient groups with significantly different survival probabilities (P < .0001).
- A threshold of 3 mitoses per HPF was suggested as a more valid prognostic indicator than the common threshold of 10.
- Mitotic frequency counting provided additional prognostic information beyond tumor size, lymph node status, and DNA ploidy.
Conclusions:
- Mitotic figure counting is a valuable and reproducible tool for assessing breast cancer malignancy and predicting patient outcomes.
- This method offers higher prognostic significance than several established parameters.
- The findings support the integration of mitotic figure counting into routine breast cancer assessment for improved patient management.