The changing importance of prognostic factors in breast cancer during long‐term follow‐up

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Abstract
A cohort of 464 breast‐cancer patients were followed up for over 10 years and the clinical, histological and morphometric factors were related to survival within different time periods during follow‐up. Tumor diameter, axillary lymph‐node status (pN), tubule formation and the fraction of intraductal growth as determined from the primary tumor biopsy specimen had prognostic value up to 5 years. Histological grade, morphometric nuclear factors and the M/V index had only short‐term prognostic value immediately after the primary therapy. In axillary lymph‐node‐negative (ANN) tumors tubule formation, intraductal growth, tumor necrosis and tumor diameter had prognostic value during the first 3 postoperative years. In axillary lymph‐node‐positive (ANP) tumors, tumor diameter, intraductal growth and tubule formation had long‐term prognostic value whereas the M/V index had prognostic value only for 1 postoperative year. Tumor diameter, axillary lymph‐node status, tubule formation and the proportion of intraductal growth also had independent long‐term prognostic value in a multivariate analysis and accordingly these factors can categorize breast‐cancer patients into prognostic groups after several years of follow‐up. In contrast, mitotic frequency loses its prognostic power within 2 postoperative years, while morphometric nuclear factors and histological grade have no practical prognostic value after 1 year of follow‐up.© 1992 Wifey‐Liss, Inc.