Lymphocytic infiltration of the primary breast cancer and sinus histiocytosis of the axillary lymph nodes are indications of a favorable prognosis. Similarly, skin test responsiveness such as with DNCB or with tumor extracts correlates in general with stage of disease. This presentation will bring forth preliminary data on cellular immunity of breast cancer patients. Circulating lymphocytes (PBL) were stimulated with mitogens and a breast cancer antigen. PBL from patients with a primary tumor less than 2.4 cm in size reacted as though no immune stimulus existed. PBL from patients with a lump from 2.5 to 5.0 cm in size showed evidence of immune stimulation. An increase in size of the primary tumor over 5 cm and an increase in the number of axillary lymph nodes with metastasis were associated with a diminution in cellular immunity. However, data from an adjuvant immunotherapy program show that cellular immunity can be improved in certain patients by immunization. Such patients continue to remain disease free, while patients whose cellular immunity was poor or not improved by adjuvant immunotherapy tended to develop recurrent disease.
Cancer 469393-898. 1980.
HE POOR IMMUNOLOGIC responsiveness of the pa-T tient with widespread cancer has been known for years.' Recently, data have come forth which demonstrate that breast cancer patients do react against their cancer.' Little evidence, however, is available to indicate that the host makes an immunologic response against "minimal cancer." Measurement of response to skin test antigens as well as circulating lymphocytes and serum antibodies reflects on the host's systemic immune responsiveness.
Recently, a subpopulation of T-lymphocytes has been described, which form 'active' E -r ~s e t t e s . ~ These cells have been reported to be depressed in patients with ~a n c e r , ~ and significant changes in percentages have been reported in patients following renal all0grafts.j The functional significance of this subpopulation remains unknown, but certain observations may be relevant. Thirty-seven degree centigrade stable E-rosettes were formed by the majority of the T-lymphocytes in the human thymus6; 'active' rosette numbers are depressed in patients with immunodeficiency disease," and significant increases in 'active' rosette numbers were observed following intratumor BCG inoculation7 and transfer factor therapy.8 Those observations taken to-