Pathologic Identification of Poor Prognosis Stage I (T1N0M0) Cancer of the Breast

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Abstract
Twenty-40% of Stage I(T1N0M0) cancers of the breast recur in 10 yr. This is an attempt to identify those patients in whom the disease is likely to recur. On the basis of a study of the histologic changes in the tumor and treatment failures poor prognosis was associated with the following histological characteristics: poor cytologic differentiation, lymphatic permeation, blood vessel invasion and invasion of the tumor into the surrounding soft tissue. This classification was then applied to 363 cancers of the breast seen over a 5 yr period and followed 3-8 yr. There were 203 Stage I (T1N0M0) tumors in the group. Of the 203 Stage I tumors (94) had 1-4 of the above histologic characteristics; 109 had none. Among the 109 patients characterized as good risks there were 2 treatment failures (2%). In the group of 94 with any high risk histologic features there were 47 treatment failures (50%) which were statistically significant (P = 0.001). The histologic changes had a cumulative effect on the degree of malignancy of the tumor. Pathologic changes in the tumor identified those patients whose Stage I (T1N0M0) tumors were likely to recur.