Long-term survival of T1 and T2 lymph node-negative breast cancer patients according to mitotic activity index: A population-based study
✍ Scribed by W.J. Louwman; M.W.P.M. van Beek; R.F.M. Schapers; M.B.C.J.E. Tutein Nolthenius-Puylaert; P.J. van Diest; R.M. Roumen; J.W.W. Coebergh
- Publisher
- John Wiley and Sons
- Year
- 2006
- Tongue
- French
- Weight
- 170 KB
- Volume
- 118
- Category
- Article
- ISSN
- 0020-7136
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✦ Synopsis
Abstract
Node‐negative breast cancer patients have a relatively good prognosis, but eventually one‐third will die of the disease. Thus, prognostic factors to identify the high‐risk group among these patients are needed. We retrospectively determined the Mitotic Activity Index (MAI) for a large series of node‐negative breast cancer patients (n = 468) with tumours smaller than 5 cm, who only received locoregional treatment. Patients were followed for up to 29 years; crude and relative survival were calculated, both univariate and multivariate. Relative survival differed significantly according to MAI (p = 0.05), the difference occurred in the first 5 years after diagnosis and remained constant thereafter. After adjustment, MAI still significantly affected relative survival (RER, 1.9; 95% CI, 1.1–3.5). Tumour size also increased the risk, but this was not statistically significant (RER, 1.5; 95% CI, 0.8–2.7). Survival of patients with a T1 tumour and MAI < 10 was similar to that for the general population in the first 5 years after diagnosis. In conclusion, MAI significantly predicted long‐term survival for T1/T2N0 breast cancer. Adjuvant systemic therapy appears to have little benefit for node‐negative breast cancer patients with a T1 tumour, regardless of the MAI. For those with a T2 tumour and a MAI ≥ 10 systemic therapy might have reduced mortality. The need for close surveillance of node‐negative breast cancer patients with a T1 tumour and MAI <10 seems limited. © 2005 Wiley‐Liss, Inc.