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Related Experiment Videos

Morphometric grading in breast cancer: thresholds for mitotic counts

P Kronqvist1, T Kuopio, Y Collan

  • 1Department of Pathology, University of Turku, Finland.

Human Pathology
|December 29, 1998
PubMed
Summary

New quantitative thresholds for mitotic activity in invasive ductal breast cancer can improve disease grading. These mitotic activity index (MAI) and standardized mitotic index (SMI) thresholds predict patient outcomes more effectively than traditional factors.

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Area of Science:

  • Oncology
  • Pathology
  • Biostatistics

Background:

  • Invasive ductal breast cancer grading is crucial for prognosis.
  • Current grading systems may benefit from more objective quantitative measures.
  • Mitotic activity is a known prognostic indicator in breast cancer.

Purpose of the Study:

  • To establish quantitative thresholds for mitotic activity in invasive ductal breast cancer.
  • To evaluate the prognostic value of these thresholds in predicting patient survival and recurrence.
  • To compare the predictive power of mitotic activity thresholds with established prognostic factors.

Main Methods:

  • Analysis of 364 invasive ductal breast cancer cases diagnosed between 1988-1991.
  • Calculation of standardized mitotic index (SMI) and mitotic activity index (MAI).

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  • Application of Kaplan-Meier curves, Cox regression, and ROC analysis to determine optimal thresholds based on survival and recurrence data.

    • Main Results:

    • Two thresholds were identified for SMI (17 and 32 mitoses/mm²) and MAI (13 and 35 mitoses/10 HPF).
    • These thresholds effectively stratified patients into favorable, intermediate, and unfavorable outcome groups.
    • Mitotic activity thresholds demonstrated a higher risk of breast cancer death compared to menopausal status, lymph node status, and tumor size, particularly in specific patient subgroups.

    Conclusions:

    • The identified quantitative thresholds for SMI and MAI can be reliably applied for grading invasive ductal breast cancer.
    • These thresholds offer a more precise prognostic tool than traditional factors.
    • Further validation of these quantitative thresholds in larger cohorts is warranted.