Author/Editor     Pinder, SE; Murray, S; Ellis, O; Trihia, H; Elston, CW; Gelber, RD; Goldhirsch, A; Lindtner, J; Cortes-Funes, H; Simoncini, E; Byrne, MJ; Golouh, R
Title     The importance of the histologic grade of invasive breast carcinoma and response to chemotherapy
Type     članek
Source     Cancer
Vol. and No.     Letnik 83, št. 8
Publication year     1998
Volume     str. 1529-39
Language     eng
Abstract     Background. Histologic grade is well recognized for its prognostic significance in cases of primary operable invasive breast carcinoma; however, the majority of studies in which grade has been assessed have been based on single-center trials. In addition, the role of grade in predicting response to chemohterapy has not been examined in many previous studies. Method. The authors assessed the vallue of Nottingham histologic grade (NHG) in a group of 465 patients enrolled in multicenter, randomized International Breast Cancer Study Group clinical trial of adjuvant Chemotherapy for patients with lymph node (LN) positive and LN negative primary breast carcinoma (formerly named Ludwig Trial V). Results. NHG was predictor of overall survival for both LN negative and LN positive patients (P=0.045 and P<0.001, respectively). NHG was associated with a poorer prognosis for both LN positive and LN negative patients, with hazard ratios of 1.651 (P<0.001) and 1.437 (P=0.045), respectively, for an increase of one grade. Among LN negative patients, this survival disadvantage was observed only for those who received perioperative chemotherapy. For LN positive patients, an increase of one grade resulted in a significant overall survival disadvantage regardless of whether prolonged or perioperative chemotherapy was given. For LN negative patients grouped by grade, there was no observed difference in overall or disease free survival according to whewther perioperative chemotherapy or no adjuvant therapy was given. However, LN positive patients with Grade 3 tumots had a significantly greater overall and disease free survival benefit from prolonged chemotherapy than from perioperative chemotherapy (P=0.016 and P=0.013, respectively); LN positive patients with Grade 1 or 2 disease in both treatment arms had comparable overall and disease free survival. (Abstract truncated at 2000 characters)
Descriptors     BREAST NEOPLASMS
NEOPLASM STAGING
COHORT STUDIES
PROGNOSIS
SURVIVAL ANALYSIS