Proliferative activity measured by flow cytometry and Ki‐67 of nodal negative breast cancer as a prognostic parameter for local recurrences and distant metastases ‐first results

Abstract

AbstractThe prognostic value of proliferative activity [percentage of S‐phase cells = S‐phase fraction (SPF) and Ki‐67] was determined in nodal negative breast carcinomas and correlated with no evidence of disease (NED) survival and analysis of recurrence. Overall 193 breast carcinomas were investigated. SPF of 183 breast carcinomas was determined by one‐dimensional flow cytometry. Histochemically the percentage of Ki‐67‐positive cells was measured in 188 patients. Slowly proliferating tumors determined by SPF (SPF < median) had a better 5‐year NED survival (91%), a lower rate of distant metastases (1%), and a lower rate of loco‐regional recurrences (4.5%) compared to fast proliferating tumors (SPF > median; NED survival 63%; distant metastases 15.7%; loco‐regional recurrences 21%). Slowly proliferating tumors determined by Ki‐67 (Ki‐67 < 20%) had a better 5‐year NED survival (77%) and a lower rate of distant metastases (6.1%) compared to fast proliferating tumors (percentage of Ki‐67‐positive cells > 20%; NED survival 63%; distant metastases 17.9%). However, there was no significant difference in loco‐regional control. Stepwise multivariate analysis showed that SPF (P = 0.002) was the only independent prognostic factor for NED survival: SPF in interaction with grading (P = 0.001) and family history (P = 0.044) for distant metastases; and SPF (P = 0.0039), method of surgical treatment (P = 0.071), and grading (P = 0.0956) for loco‐regional recurrences. In conclusion, proliferative activity is a relevant prognostic parameter for nodal negative breast Cancer. © Wiley‐Liss, Inc.