BIOLOGIC AND CLINICOPATHOLOGICAL FACTORS AS INDICATORS OF SPECIFIC RELAPSE TYPES IN NODE-NEGATIVE BREAST-CANCER

Purpose and Methods: We evaluated, in 1,800 patients with node-negative tumors treated with locoregional therapy until relapse, the competitive risks for different types of metastasis by cell proliferation (H-3-thymidine labeling index [H-3-dT LI]), estrogen receptors (ERs), and progesterone receptors (PgRs), and by the integration of biologic and clinicopathologic information. Results: Hormone receptor status and proliferative activity of the primary rumor were not indicative of contralateral failures. Hormone receptors failed to predict the 8-year incidence of locoregional recurrence, bur they were significant indicators of distant metastasis and overall survival. The latter finding was confirmed even in multivariate analysis. Conversely, cell proliferation predicted both locoregional and distant metastases and survival, regardless of patient age, tumor size, and ER and PgR status. Recursive partitioning and amalgamation analysis ascribed to cell proliferation an important prognostic role for locoregional recurrence together with patient age, and for distant metastasis together with patient age and tumor size. Conclusion: Biologic markers, in particular cell proliferation, provide information for the different types of relapse and could complement the predictive role of pathologic staging. (C) 1995 by American Society of Clinical Oncology.