Abstract
The clinical course of breast cancer was related to degree of anaplasia (DA) and steroid receptor (SR) content of primary tumours in 743 patients (pts) with clinical recurrence, initially enrolled in the DBCG-77 protocols. The oestrogen receptor (ER) and the progesterone receptor (PgR) content was known in 110 and 67 pts. The recurrence-free interval, survival after recurrence, and the overall survival were all prolonged in patients with well differentiated tumours or with high SR content. The tumour growth rates were estimated as clinical rates of progression (i.e., the time elapsed from a single distant metastasis until dissemination). The progression rate was prolonged in relatively well differentiated as well as in receptor rich tumours. The extent of dissemination, as indicated by the number of metastatic sites, was not associated with either DA or SR content. However, the anatomical distribution of metastases varied with both DA and SR content: signs of poor prognosis (high DA or low SR content) were associated with occurrence of visceral metastases. In contrast, SR rich tumours had a propensity for recurrence in bone. The results suggest that the impact on prognosis of the features examined here includes both variations in growth rate and metastatic pattern.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Adami H. O., Graffman S., Lindgren A., Sällström J. Prognostic implication of estrogen receptor content in breast cancer. Breast Cancer Res Treat. 1985;5(3):293–300. doi: 10.1007/BF01806024. [DOI] [PubMed] [Google Scholar]
- Andersen K. W., Mouridsen H. T., Castberg T., Fischerman K., Andersen J., Hou-Jensen K., Brincker H., Johansen H., Henriksen E., Rørth M. Organisation of the Danish adjuvant trials in breast cancer. Dan Med Bull. 1981 Aug;28(3):102–106. [PubMed] [Google Scholar]
- BLOOM H. J., RICHARDSON W. W. Histological grading and prognosis in breast cancer; a study of 1409 cases of which 359 have been followed for 15 years. Br J Cancer. 1957 Sep;11(3):359–377. doi: 10.1038/bjc.1957.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
- BROSS I. D. Is there an increased risk? Fed Proc. 1954 Sep;13(3):815–819. [PubMed] [Google Scholar]
- Brinkley D., Haybrittle J. L. The curability of breast cancer. Lancet. 1975 Jul 19;2(7925):95–97. doi: 10.1016/s0140-6736(75)90003-3. [DOI] [PubMed] [Google Scholar]
- Bunting J. S., Hemsted E. H., Kremer J. K. The pattern of spread and survival in 596 cases of breast cancer related to clinical staging and histological grade. Clin Radiol. 1976 Jan;27(1):9–15. doi: 10.1016/s0009-9260(76)80004-9. [DOI] [PubMed] [Google Scholar]
- Campbell F. C., Blamey R. W., Elston C. W., Morris A. H., Nicholson R. I., Griffiths K., Haybittle J. L. Quantitative oestradiol receptor values in primary breast cancer and response of metastases to endocrine therapy. Lancet. 1981 Dec 12;2(8259):1317–1319. doi: 10.1016/s0140-6736(81)91341-6. [DOI] [PubMed] [Google Scholar]
- Clark G. M., Sledge G. W., Jr, Osborne C. K., McGuire W. L. Survival from first recurrence: relative importance of prognostic factors in 1,015 breast cancer patients. J Clin Oncol. 1987 Jan;5(1):55–61. doi: 10.1200/JCO.1987.5.1.55. [DOI] [PubMed] [Google Scholar]
- Coleman R. E., Rubens R. D. The clinical course of bone metastases from breast cancer. Br J Cancer. 1987 Jan;55(1):61–66. doi: 10.1038/bjc.1987.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Coombes R. C., Dady P., Parsons C., McCready V. R., Ford H. T., Gazet J. C., Powles T. J. Assessment of response of bone metastases to systemic treatment in patients with breast cancer. Cancer. 1983 Aug 15;52(4):610–614. doi: 10.1002/1097-0142(19830815)52:4<610::aid-cncr2820520406>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
- Cuzick J., Baum M. Tamoxifen and contralateral breast cancer. Lancet. 1985 Aug 3;2(8449):282–282. doi: 10.1016/s0140-6736(85)90338-1. [DOI] [PubMed] [Google Scholar]
- Heuson J. C., Longeval E., Mattheiem W. H., Deboel M. C., Sylvester R. J., Leclercq G. Significance of quantitative assessment of estrogen receptors for endocrine therapy in advanced breast cancer. Cancer. 1977 May;39(5):1971–1977. doi: 10.1002/1097-0142(197705)39:5<1971::aid-cncr2820390510>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
- Hietanen P., Miettinen M., Mäkinen J. Survival after first recurrence in breast cancer. Eur J Cancer Clin Oncol. 1986 Aug;22(8):913–919. doi: 10.1016/0277-5379(86)90056-8. [DOI] [PubMed] [Google Scholar]
- Kamby C., Rose C., Ejlertsen B., Andersen J., Birkler N. E., Rytter L., Andersen K. W., Zedeler K. Adjuvant systemic treatment and the pattern of recurrences in patients with breast cancer. Eur J Cancer Clin Oncol. 1988 Mar;24(3):439–447. doi: 10.1016/s0277-5379(98)90014-1. [DOI] [PubMed] [Google Scholar]
- Kamby C., Rose C., Ejlertsen B., Andersen J., Birkler N. E., Rytter L., Andersen K. W., Zedeler K. Stage and pattern of metastases in patients with breast cancer. Eur J Cancer Clin Oncol. 1987 Dec;23(12):1925–1934. doi: 10.1016/0277-5379(87)90061-7. [DOI] [PubMed] [Google Scholar]
- Meyer J. S., Prey M. U., Babcock D. S., McDivitt R. W. Breast carcinoma cell kinetics, morphology, stage, and host characteristics. A thymidine labeling study. Lab Invest. 1986 Jan;54(1):41–51. [PubMed] [Google Scholar]
- Nowell P. C. The clonal evolution of tumor cell populations. Science. 1976 Oct 1;194(4260):23–28. doi: 10.1126/science.959840. [DOI] [PubMed] [Google Scholar]
- Poste G., Fidler I. J. The pathogenesis of cancer metastasis. Nature. 1980 Jan 10;283(5743):139–146. doi: 10.1038/283139a0. [DOI] [PubMed] [Google Scholar]
- Qazi R., Chuang J. L., Drobyski W. Estrogen receptors and the pattern of relapse in breast cancer. Arch Intern Med. 1984 Dec;144(12):2365–2367. [PubMed] [Google Scholar]
- Rank F., Dombernowsky P., Jespersen N. C., Pedersen B. V., Keiding N. Histologic malignancy grading of invasive ductal breast carcinoma. A regression analysis of prognostic factors in low-risk carcinomas from a multicenter trial. Cancer. 1987 Sep 15;60(6):1299–1305. doi: 10.1002/1097-0142(19870915)60:6<1299::aid-cncr2820600623>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
- Samaan N. A., Buzdar A. U., Aldinger K. A., Schultz P. N., Yang K. P., Romsdahl M. M., Martin R. Estrogen receptor: a prognostic factor in breast cancer. Cancer. 1981 Feb 1;47(3):554–560. doi: 10.1002/1097-0142(19810201)47:3<554::aid-cncr2820470322>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
- Singhakowinta A., Saunders D. E., Brooks S. C., Samal B., Vaitkevicius V. K. Clinical application of estrogen receptor in breast cancer. Cancer. 1980 Dec 15;46(12 Suppl):2932–2938. doi: 10.1002/1097-0142(19801215)46:12+<2932::aid-cncr2820461439>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
- Stenkvist B., Westman-Naeser S., Vegelius J., Holmquist J., Nordin B., Bengtsson E., Eriksson O. Analysis of reproducibility of subjective grading systems for breast carcinoma. J Clin Pathol. 1979 Oct;32(10):979–985. doi: 10.1136/jcp.32.10.979. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stewart J. F., King R. J., Sexton S. A., Millis R. R., Rubens R. D., Hayward J. L. Oestrogen receptors, sites of metastatic disease and survival in recurrent breast cancer. Eur J Cancer. 1981 Apr;17(4):449–453. doi: 10.1016/0014-2964(81)90254-1. [DOI] [PubMed] [Google Scholar]
- Straus M. J., Moran R., Muller R. E., Wotiz H. H. Estrogen receptor heterogeneity and the relationship between estrogen receptor and the tritiated thymidine labeling index in human breast cancer. Oncology. 1982;39(4):197–200. doi: 10.1159/000225636. [DOI] [PubMed] [Google Scholar]
- Valentin-Opran A., Eilon G., Saez S., Mundy G. R. Estrogens and antiestrogens stimulate release of bone resorbing activity by cultured human breast cancer cells. J Clin Invest. 1985 Feb;75(2):726–731. doi: 10.1172/JCI111753. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vincent M. D., Powles T. J., Skeet R., Ashley S., Coombes R. C., Gibb J., Clarke S., Thomas H. L., Adcock H. An analysis of possible prognostic features of long term and short term survivors of metastatic breast cancer. Eur J Cancer Clin Oncol. 1986 Sep;22(9):1059–1065. doi: 10.1016/0277-5379(86)90006-4. [DOI] [PubMed] [Google Scholar]
- Walt A. J., Singhakowinta A., Brooks S. C., Cortez A. The surgical implications of estrophile protein estimations in carcinoma of the breast. Surgery. 1976 Oct;80(4):506–512. [PubMed] [Google Scholar]