S-phase Fraction as an Independent Prognostic Factor in Invasive Breast Carcinoma -A Study of Long-term Follow-up

Jin Hae Bae; Jeong Won Bae; Sang Uk Woo; Chul Whan Kim; Jae Bok Lee; Gil Soo Son; Byum Whan Koo

doi:10.4048/jbc.2007.10.1.36

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Bae, Bae, Woo, Kim, Lee, Son, and Koo: S-phase Fraction as an Independent Prognostic Factor in Invasive Breast Carcinoma -A Study of Long-term Follow-up

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2007; 10(1): 36-42.

Published online: 31 March 2007

DOI: https://doi.org/10.4048/jbc.2007.10.1.36

S-phase Fraction as an Independent Prognostic Factor in Invasive Breast Carcinoma -A Study of Long-term Follow-up

Jin Hae Bae, Jeong Won Bae, Sang Uk Woo, Chul Whan Kim¹, Jae Bok Lee, Gil Soo Son, Byum Whan Koo

Department of Sugery, Korea University College of Medicine, Seoul, Korea.

¹Department of Pathology, Korea University College of Medicine, Seoul, Korea.

kujwbae@korea.ac.kr

Received 8 November 2006 Accepted 14 February 2007

Abstract

Purpose

To evaluate the significance of the S-phase fraction (SPF) and DNA ploidy, determined by DNA flow cytometry, as prognostic markers in invasive breast cancer.

Methods

Between October 1986 and June 1999, 143 breast carcinoma patients, treated by surgery, were analyzed. Flow cytometry was performed for the identification of the SPF and DNA ploidy, with immunohistochemistry performed on paraffin embedded material for the hormone receptor. Two SPF classes were defined on the basis of the median value (10) by using a log rank test (high SPF>10, low SPF<10). The correlation between SPF and the clinicopathological factors (tumor size, lymph node status, histological grade and steroid receptor status) and between the SPF and 5 yr disease-free survival (DFS) were investigated.

Results

DNA ploidy was not associated with tumor size, lymph node status, histological grade, overall survival and DFS. In a univariate analysis, high SPF values were associated with shorter 5 yr DFS in individual groups. In the node negative group, the 5 yr DFS of the low SPF group was higher than that of the high SPF group, but in the node positive group, the SPF values showed statistical significance with the 5 yr DFS. In a multivariate analysis, the SPF was independently associated with the 5 yr DFS in the node negative group.

Conclusion

These results suggested the SPF is an independent prognostic factor in lymph node negative, estrogen receptor positive and progesterone receptor negative breast cancers.

Keywords: Invasive ductal carcinoma, Flowcytometry, S-phase fraction, Prognosis

Figures and Tables

Fig 1

Univariate survival analysis according to s-phase fraction tertiles: overall survival (A) and disease free survival (B) in the overall patients.

Fig 2

Disease free survival according to s-phase fraction tertiles in subgroups. (A) T2 patient, (B) T3 patient, (C) node-negative patients, (D) node-positive patients.

Fig 3

Disease free survival according to s-phase fraction tertiles in subgroups. (A) estrogen receptor positive patient, (B) estrogen receptor negative patient, (C) progesterone receptor negative patients, (D) progesterone receptor positive patients.

Table 1

Correlation between pathologic characteristics and S-phase fraction

SPF=S-phase fraction; ER=estrogen receptor; PR=progesterone receptor.

Table 2

Multivariate analysis for overall population and TNM classification for disease free survival

RR=Relative Risk; PR=progesterone receptor; SPF=S-phase fraction; NS=no significant.

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