Long-term survival of T1 and T2 lymph node-negative breast cancer patients according to mitotic activity index: A population-based study

W. J. Louwman, M. W P M Van Beek, R. F M Schapers, M. B C J E Tutein Nolthenius-Puylaert, P. J. Van Diest, R. M. Roumen, J. W W Coebergh

Research output: Contribution to journalArticlepeer-review

Abstract

Node-negative breast cancer patients have a relatively good prognosis, but eventually one-third will die of the disease. Thus, prognostic factors to identify the high-risk group among these patients are needed. We retrospectively determined the Mitotic Activity Index (MAI) for a large series of node-negative breast cancer patients (n = 468) with tumours smaller than 5 cm, who only received locoregional treatment. Patients were followed for up to 29 years; crude and relative survival were calculated, both univariate and multivariate. Relative survival differed significantly according to MAI (p = 0.05), the difference occurred in the first 5 years after diagnosis and remained constant thereafter. After adjustment, MAI still significantly affected relative survival (RER, 1.9; 95% CI, 1.1-3.5). Tumour size also increased the risk, but this was not statistically significant (RER, 1.5; 95% CI, 0.8-2.7). Survival of patients with a T1 tumour and MAI <10 was similar to that for the general population in the first 5 years after diagnosis. In conclusion, MAI significantly predicted long-term survival for T1/T2N0 breast cancer. Adjuvant systemic therapy appears to have little benefit for node-negative breast cancer patients with a T1 tumour, regardless of the MAI. For those with a T2 tumour and a MAI ≥ 10 systemic therapy might have reduced mortality. The need for close surveillance of node-negative breast cancer patients with a T1 tumour and MAI

Original languageEnglish (US)
Pages (from-to)2310-2314
Number of pages5
JournalInternational Journal of Cancer
Volume118
Issue number9
DOIs
StatePublished - May 1 2006
Externally publishedYes

Keywords

  • Breast cancer
  • Long-term prognosis
  • Mitotic activity index (MAI)

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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