Abstract P1-07-06: The relationship between Klintrup-Makinen score and cancer-specific survival in primary operable breast cancer

Abstract

Abstract Introduction It is increasingly being recognised that cancer prognosis is dependent on a complex interaction of tumour factors and the host response. The degree of inflammatory response at the invasive tumour edge, as measured by the Klintrup-Makinen score, has been shown to have prognostic relevance in some cancers but its role in breast cancer remains unclear. Aim To evaluate the relationship between Klintrup-Makinen score and prognosis in primary operable breast cancer. Methods Patients who underwent surgery for primary operable invasive breast cancer between 1995 and 2007 were studied. Full section haematoxylin and eosin slides from surplus tissue from each breast cancer were analysed. Each was visually scored for the level of inflammatory infiltrate at the invasive edge of the tumour, according to Klintrup-Makinen criteria. Kaplan Meier survival analysis was performed using SPSS. Results 1195 patients were included in the study, of which 298 had a Klintrup-Makinen score (KM) of 0 (no inflammatory cells at the invasive edge), 589 had a score of 1, 238 had a score of 2 and 70 had a Klintrup-Makinen score of 3 (high inflammatory cell infiltrate). 833 (69.7%) patients were ER positive and 172 (14.4%) patients were HER2 positive. Median follow up was 158 months (28-183) and there were 234 cancer deaths. Patients with the highest and lowest KM scores had the best prognosis (10 year breast cancer specific survival (BCSS) 84% for KM score 3 and 82% for KM score 0), while those with KM score 2 had the worst prognosis with 67% 10 year cancer specific survival (p=0.003). When analysed by subtype, in ER negative patients 10 year BCSS was 95% in KM 0 patients, 80% for KM 3, 72% for KM 1 and 67% for KM 2 (p=0.082). Conversely, in HER2 positive patients, the best prognosis was seen in patients with KM 3 with 86% 10 year BCSS but patients with KM 0 had the worst prognosis (BCSS 62%), but this did not reach significance (p=0.544). Conclusion The Klintrup-Makinen score appears to have a prognostic role in primary operable invasive breast cancer, however there is a suggestion that it varies between tumour subtypes. Further work is required to further define this role for each molecular subtype. Citation Format: Morrow ES, Gujam F, Mohammed ZMA, McMillan DC, Edwards J. The relationship between Klintrup-Makinen score and cancer-specific survival in primary operable breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-07-06.