DNA ploidy and cytonuclear area of peritumoral and paratumoral samples of mastectomy specimens: a useful prognostic marker?

摘要

OBJECTIVE: To investigate a possible relationship between DNA alterations in the "normal" residual mammary tissue of patients with breast cancer and survival. DESIGN: Prospective study. SETTING: University hospital, Spain. SUBJECTS: 162 patients operated on for breast cancer between 1991 and 1995. MAIN OUTCOME MEASURES: Cytology, histopathology, optic karyometry, DNA ploidy, and S-phase fraction measured by flow cytometry in peritumoral and paratumoral tissue. Mortality, and univariate analysis. RESULTS: DNA ploidy in peritumoral tissue was altered in 42 patients (26%), in 41 of whom the mean cytonuclear area was also altered. Of the 19 patients whose death within the study period was attributed to their cancer, 13 had peritumoral tissue in which both DNA ploidy and mean cytonuclear area were altered. On univariate analysis, there was significantly worse survival among the patients in whom both tumoral and peritumoral tissues were DNA aneuploid than among those in whom only tumoural tissue was DNA aneuploid (p < 0.0001). CONCLUSIONS: The presence of peritumoral or paratumoral tissue or both, with anomalous DNA content is associated with a reduced survival among women whose breast cancer has been treated by mastectomy. Additional studies including multivariate analysis are necessary to confirm our findings.