DNA ploidy and breast cancer-A retrospective study of paraffin-embedded tissues wtth 5 year follow-up

Abstract

Over the past 7 years increasing demand has occurred for better prognostic Indicators of breast cancer. Besides the traditional factors of tumour size, type, grade and lymph node status, oestrogen receptor assay has now become a mandatory laboratory assay and there is increasing clinical demand for DNA quantitation, cell cycle analyses with S-phase fraction studies, MDR markers and proliferative activity. At Cauifield General Medical Centre we have studied 86 consecutive breast biopsies in which a diagnosis of carcinoma was made in 1985/*86. In each case frozen section reports matched the final paraffin section assessment. In 79 cases a diagnosis of in-situ or infiltrating duct carcinoma was made. Two cases each of infiltrating lobular, mucinous and papillary carcinoma and a single medullary carcinoma was identified. In each case a single block of paraffin-embedded formalin - fixed tissue was selected tor DNA pioidy assessment. The tissue was processed by a method slightly modified from Hedleys original description in 1983. The single cell suspension was stained with propidlum Iodide and analysed In a Coulter Epics Profile II. The smallest cell yield was 2750 cells and the largest 45,000. The mean CV was 7.1. DNA ploldy and S-phase fraction assessments were performed using Phoenix Multicyle software on an Arrow 386, 33 mHz computer with an Intel 387 Chip. Of the 86 carcinomas 46 were DNA diploid, 23 aneuploid and 17 tetraploid. Age distribution showed peak incidence in 7th & 8th decades with a mean tumour size of 22mm. Over half the patients were node negative (49/86). In our series survival curves show patients with Infiltrating duct carcinomas who present in the 6th & 7th decade who are node negative and have diploid tumours have a far superior 5 year survival (70%). Over the past 7 years increasing demand has occurred for better prognostic Indicators of breast cancer. Besides the traditional factors of tumour size, type, grade and lymph node status, oestrogen receptor assay has now become a mandatory laboratory assay and there is increasing clinical demand for DNA quantitation, cell cycle analyses with S-phase fraction studies, MDR markers and proliferative activity. At Cauifield General Medical Centre we have studied 86 consecutive breast biopsies in which a diagnosis of carcinoma was made in 1985/*86. In each case frozen section reports matched the final paraffin section assessment. In 79 cases a diagnosis of in-situ or infiltrating duct carcinoma was made. Two cases each of infiltrating lobular, mucinous and papillary carcinoma and a single medullary carcinoma was identified. In each case a single block of paraffin-embedded formalin - fixed tissue was selected tor DNA pioidy assessment. The tissue was processed by a method slightly modified from Hedleys original description in 1983. The single cell suspension was stained with propidlum Iodide and analysed In a Coulter Epics Profile II. The smallest cell yield was 2750 cells and the largest 45,000. The mean CV was 7.1. DNA ploldy and S-phase fraction assessments were performed using Phoenix Multicyle software on an Arrow 386, 33 mHz computer with an Intel 387 Chip. Of the 86 carcinomas 46 were DNA diploid, 23 aneuploid and 17 tetraploid. Age distribution showed peak incidence in 7th & 8th decades with a mean tumour size of 22mm. Over half the patients were node negative (49/86). In our series survival curves show patients with Infiltrating duct carcinomas who present in the 6th & 7th decade who are node negative and have diploid tumours have a far superior 5 year survival (70%).