Proliferation markers predictive of the pathological response and disease outcome of patients with breast carcinomas treated by anthracycline-based preoperative chemotherapy

Vincent-Salomon, Anne, Rousseau, Alexandra, Jouve, Michel, Beuzeboc, Philippe, Sigal-Zafrani, Brigitte, Freneaux, Paul, Rosty, Christophe, Nos, Claude, Campana, Francois, Klijanienko, Jerzy, Al Ghuzlan, Abir and Sastre-Garau, Xavier (2004) Proliferation markers predictive of the pathological response and disease outcome of patients with breast carcinomas treated by anthracycline-based preoperative chemotherapy. European Journal of Cancer, 40 10: 1502-1508. doi:10.1016/j.ejca.2004.03.014


Author Vincent-Salomon, Anne
Rousseau, Alexandra
Jouve, Michel
Beuzeboc, Philippe
Sigal-Zafrani, Brigitte
Freneaux, Paul
Rosty, Christophe
Nos, Claude
Campana, Francois
Klijanienko, Jerzy
Al Ghuzlan, Abir
Sastre-Garau, Xavier
Title Proliferation markers predictive of the pathological response and disease outcome of patients with breast carcinomas treated by anthracycline-based preoperative chemotherapy
Journal name European Journal of Cancer   Check publisher's open access policy
ISSN 0959-8049
1879-0852
Publication date 2004-07
Sub-type Article (original research)
DOI 10.1016/j.ejca.2004.03.014
Volume 40
Issue 10
Start page 1502
End page 1508
Total pages 7
Place of publication Kidlington, Oxford, United Kingdom
Publisher Pergamon
Language eng
Formatted abstract
The cell proliferation rate has been correlated to the response of breast carcinomas to preoperative chemotherapy (CT) and to disease outcome. However, this parameter is not yet used to select which tumours should be treated with preoperative CT. Furthermore, there is no consensus in the method used to evaluate cell proliferation. In poor prognosis breast carcinomas (PPBCs) treated by intensive preoperative CT, we compared the predictive value of S phase fraction (SPF), mitotic index (MI) and Ki67. We also evaluated the prognostic significance of the variation of the MI after CT. A series of 55 T2-T4N0N1M0 breast carcinomas were treated with 4 cycles of cyclophosphamide, 5-fluorouracil (5-FU) and doxorubicin. SPF was determined by flow cytometry on pre-therapeutic needle aspiration products. MI and Ki67 were evaluated on pre-therapeutic biopsy samples and on the tumours after CT. Fifteen patients (27%) had a pathological complete response (pCR), whereas 40 (73%) had residual disease. All three proliferative markers were found to have predictive value, but this value was higher for MI than for SPF (P=0.04) and Ki67 (P=0.03): the rate of pCR was 50% in cases with MI>17/3.3 mm 2, but was only 7% in cases with MI under this threshold (P=0.0003). A significant decrease of MI (mean 10.97) was observed after CT (P=0.001). Furthermore, we observed that even for patients with residual tumour, the variation of MI after CT was a prognostic parameter and overall survival. The sequential analysis of MI in breast cancers treated by preoperative CT thus provides a surrogate for predicting long-term outcome.
Keyword Preoperative chemotherapy (CT)
Mitotic index
Predictive markers
Proliferation markers
Prognostic markers
Pathological response
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Wed, 09 Mar 2011, 14:24:23 EST