Prognostic value of DNA flow cytometry in the locally recurrent, conservatively treated breast cancer patient

Bruce G. Haffty, Margaret Toth, Stuart Flynn, Diana Fischer, Darryl Carter

Research output: Contribution to journalArticle

Abstract

Purpose: This study attempted to determine the prognostic value of DNA flow cytometry in the treatment of patients with locally recurrent, conservatively treated breast cancer. Methods and Materials: Of 433 patients with clinical stage I and II breast cancer treated with conservative surgery and radiotherapy at Yale-New Haven Hospital before January 1985, 50 patients experienced an ipsilateral breast relapse as a first site of treatment failure. Using standard flow-cytometric techniques, DNA ploidy, DNA index, and S-phase fraction (SPF) were measured for 38 of the 50 (76%) paraffin-embedded specimens available for analysis. Results: At a median postrecurrence follow-up of 5.8 years, the 5-year and disease-free survival rates following ipsilateral breast treatment failure were 48% and 54%, respectively. Sixty-three percent of the recurrent tumors were DNA diploid and 37% were aneuploid. Both DNA ploidy and SPF were statistically significant prognostic indicators for 5-year survival and disease-free survival after local recurrence. The 5-year survival rate of the DNA diploid population was 64%, compared with 15% in the aneuploid population (P <.02). Patients with low SPF (<12%) experienced an 83% 5-year survival rate, com pared with a 24% 5-year survival rate in patients with high SPF (≥ 12%) (P <.03). Ploidy and SPF were combined to define the categories of favorable (diploid, low SPF) and unfavorable (diploid, high SPF or any aneuploid subgroups). Patients in the favorable category experienced an 89% 5-year postrecurrence survival rate and a 100% disease-free survival rate, whereas patients in the unfavorable category had a 24% 5-year survival rate and a 32% disease-free survival rate (P <.01). The flow cytometry as a factor correlated with other clinical parameters previously shown to be of progostic significance in this patient population. In a multivariate analysis, flow cytometry was a statistically significant and independent prognostic factor for disease-free survival following local recurrence. Conclusions: DNA ploidy and SPF as measured by currently available flow-cytometric techniques show promise as a tool in determining prognosis for the patient with locally recurrent breast cancer. Implications of these findings with respect to issues of adjuvant systemic therapy at the time of local recurrence are discussed.

Original languageEnglish (US)
Pages (from-to)1839-1847
Number of pages9
JournalJournal of Clinical Oncology
Volume10
Issue number12
StatePublished - 1992
Externally publishedYes

Fingerprint

S Phase
Flow Cytometry
Survival Rate
Breast Neoplasms
DNA
Ploidies
Disease-Free Survival
Diploidy
Aneuploidy
Recurrence
Treatment Failure
Breast
Population
Paraffin
Radiotherapy
Multivariate Analysis
Survival
Therapeutics
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Haffty, B. G., Toth, M., Flynn, S., Fischer, D., & Carter, D. (1992). Prognostic value of DNA flow cytometry in the locally recurrent, conservatively treated breast cancer patient. Journal of Clinical Oncology, 10(12), 1839-1847.

Prognostic value of DNA flow cytometry in the locally recurrent, conservatively treated breast cancer patient. / Haffty, Bruce G.; Toth, Margaret; Flynn, Stuart; Fischer, Diana; Carter, Darryl.

In: Journal of Clinical Oncology, Vol. 10, No. 12, 1992, p. 1839-1847.

Research output: Contribution to journalArticle

Haffty, BG, Toth, M, Flynn, S, Fischer, D & Carter, D 1992, 'Prognostic value of DNA flow cytometry in the locally recurrent, conservatively treated breast cancer patient', Journal of Clinical Oncology, vol. 10, no. 12, pp. 1839-1847.
Haffty, Bruce G. ; Toth, Margaret ; Flynn, Stuart ; Fischer, Diana ; Carter, Darryl. / Prognostic value of DNA flow cytometry in the locally recurrent, conservatively treated breast cancer patient. In: Journal of Clinical Oncology. 1992 ; Vol. 10, No. 12. pp. 1839-1847.
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abstract = "Purpose: This study attempted to determine the prognostic value of DNA flow cytometry in the treatment of patients with locally recurrent, conservatively treated breast cancer. Methods and Materials: Of 433 patients with clinical stage I and II breast cancer treated with conservative surgery and radiotherapy at Yale-New Haven Hospital before January 1985, 50 patients experienced an ipsilateral breast relapse as a first site of treatment failure. Using standard flow-cytometric techniques, DNA ploidy, DNA index, and S-phase fraction (SPF) were measured for 38 of the 50 (76{\%}) paraffin-embedded specimens available for analysis. Results: At a median postrecurrence follow-up of 5.8 years, the 5-year and disease-free survival rates following ipsilateral breast treatment failure were 48{\%} and 54{\%}, respectively. Sixty-three percent of the recurrent tumors were DNA diploid and 37{\%} were aneuploid. Both DNA ploidy and SPF were statistically significant prognostic indicators for 5-year survival and disease-free survival after local recurrence. The 5-year survival rate of the DNA diploid population was 64{\%}, compared with 15{\%} in the aneuploid population (P <.02). Patients with low SPF (<12{\%}) experienced an 83{\%} 5-year survival rate, com pared with a 24{\%} 5-year survival rate in patients with high SPF (≥ 12{\%}) (P <.03). Ploidy and SPF were combined to define the categories of favorable (diploid, low SPF) and unfavorable (diploid, high SPF or any aneuploid subgroups). Patients in the favorable category experienced an 89{\%} 5-year postrecurrence survival rate and a 100{\%} disease-free survival rate, whereas patients in the unfavorable category had a 24{\%} 5-year survival rate and a 32{\%} disease-free survival rate (P <.01). The flow cytometry as a factor correlated with other clinical parameters previously shown to be of progostic significance in this patient population. In a multivariate analysis, flow cytometry was a statistically significant and independent prognostic factor for disease-free survival following local recurrence. Conclusions: DNA ploidy and SPF as measured by currently available flow-cytometric techniques show promise as a tool in determining prognosis for the patient with locally recurrent breast cancer. Implications of these findings with respect to issues of adjuvant systemic therapy at the time of local recurrence are discussed.",
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AU - Toth, Margaret

AU - Flynn, Stuart

AU - Fischer, Diana

AU - Carter, Darryl

PY - 1992

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N2 - Purpose: This study attempted to determine the prognostic value of DNA flow cytometry in the treatment of patients with locally recurrent, conservatively treated breast cancer. Methods and Materials: Of 433 patients with clinical stage I and II breast cancer treated with conservative surgery and radiotherapy at Yale-New Haven Hospital before January 1985, 50 patients experienced an ipsilateral breast relapse as a first site of treatment failure. Using standard flow-cytometric techniques, DNA ploidy, DNA index, and S-phase fraction (SPF) were measured for 38 of the 50 (76%) paraffin-embedded specimens available for analysis. Results: At a median postrecurrence follow-up of 5.8 years, the 5-year and disease-free survival rates following ipsilateral breast treatment failure were 48% and 54%, respectively. Sixty-three percent of the recurrent tumors were DNA diploid and 37% were aneuploid. Both DNA ploidy and SPF were statistically significant prognostic indicators for 5-year survival and disease-free survival after local recurrence. The 5-year survival rate of the DNA diploid population was 64%, compared with 15% in the aneuploid population (P <.02). Patients with low SPF (<12%) experienced an 83% 5-year survival rate, com pared with a 24% 5-year survival rate in patients with high SPF (≥ 12%) (P <.03). Ploidy and SPF were combined to define the categories of favorable (diploid, low SPF) and unfavorable (diploid, high SPF or any aneuploid subgroups). Patients in the favorable category experienced an 89% 5-year postrecurrence survival rate and a 100% disease-free survival rate, whereas patients in the unfavorable category had a 24% 5-year survival rate and a 32% disease-free survival rate (P <.01). The flow cytometry as a factor correlated with other clinical parameters previously shown to be of progostic significance in this patient population. In a multivariate analysis, flow cytometry was a statistically significant and independent prognostic factor for disease-free survival following local recurrence. Conclusions: DNA ploidy and SPF as measured by currently available flow-cytometric techniques show promise as a tool in determining prognosis for the patient with locally recurrent breast cancer. Implications of these findings with respect to issues of adjuvant systemic therapy at the time of local recurrence are discussed.

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