Prognostic value of proliferation in invasive breast cancer: A review

P. J. Van Diest, E. Van Der Wall, J. P A Baak

Research output: Contribution to journalArticle

Abstract

Breast cancer is the leading cause of death among solid tumours in women, and its incidence is increasing in the West. Adjuvant chemotherapy and hormonal treatment improve survival but have potentially serious side effects, and are costly. Because adjuvant treatment should be given to high risk patients only, and traditional prognostic factors (lymph node status, tumour size) are insufficiently accurate, better predictors of high risk and treatment response are needed. Invasive breast cancer metastasises haematogenously very early on, so many breast cancer prognosticators are directly or indirectly related to proliferation. Although studies evaluating the role of individual proliferation regulating genes have greatly increased our knowledge of this complex process, the functional end result - cells dividing - has remained the most important prognostic factor. This article reviews the prognostic value of different proliferation assays in invasive breast cancer, and concludes that increased proliferation correlates strongly with poor prognosis, irrespective of the methodology used. Mitosis counting provides the most reproducible and independent prognostic value, and Ki67/MIB1 labelling and cyclin A index are promising alternatives that need methodological fine tuning.

Original languageEnglish (US)
Pages (from-to)675-681
Number of pages7
JournalJournal of Clinical Pathology
Volume57
Issue number7
DOIs
StatePublished - Jul 2004
Externally publishedYes

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Breast Neoplasms
Cyclin A
Adjuvant Chemotherapy
Mitosis
Cause of Death
Neoplasms
Therapeutics
Lymph Nodes
Survival
Incidence
Genes

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Prognostic value of proliferation in invasive breast cancer : A review. / Van Diest, P. J.; Van Der Wall, E.; Baak, J. P A.

In: Journal of Clinical Pathology, Vol. 57, No. 7, 07.2004, p. 675-681.

Research output: Contribution to journalArticle

Van Diest, P. J. ; Van Der Wall, E. ; Baak, J. P A. / Prognostic value of proliferation in invasive breast cancer : A review. In: Journal of Clinical Pathology. 2004 ; Vol. 57, No. 7. pp. 675-681.
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