Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Prognostic and predictive factors for breast cancer


Prognostic factors can be useful for making decisions about which patients should receive adjuvant therapy, and predictive factors can be used to predict response or lack of response to a particular therapy. We review the standard factors that are available today for primary breast cancer, and we describe some of the new, potential prognostic and predictive factors that are currently under investigation.

This is a preview of subscription content, log in to check access.



Scarff-Bloom-Richardson tumor grade


Surveillance, Epidemiology, and End Results Program of the National Cancer Institute


Estrogen receptor; PgR:Progesterone receptor


National Surgical Adjuvant Breast and Bowel Project


Thymidine labeling index




eoxyribonucleic acid


Cyclophosphamide, meth-otrexate, and 5-fluorouracil


Cyclophosphamide, doxor-ubicin, and 5-fluorouracil


Single strand conformation polymorphism


Enzyme-linked immunosorbent assay


  1. 1)

    Berg JW, Robbins GF: Factors influencing short and long-term survival of breast cancer patients.Surg Gynecol Obstet 122:1311–1316, 1966.

  2. 2)

    Fisher B, Bauer M, Wickerham DL,et al: Relation of number of positive axillary nodes to the prognosis of patients with primary breast cancer; An NSABP update.Cancer 52:1551–1557, 1983.

  3. 3)

    Saez RA, Clark GM, McGuire WL: Prognostic factors in breast cancer.Semin Surg Oncol 5:102–110, 1989.

  4. 4)

    Mittra I, MacRae KD: A meta-analysis of reported correlations between prognostic factors in breast cancer; Does axillary lymph node metastasis represent biology or chronology?Eur J Cancer 27:1574–1583, 1991.

  5. 5)

    Adair F, Berg J, Joubert L,et al: Long-term follow-up of breast cancer patients; A 30-year report.Cancer 33:1145–1150, 1974. 6) McGuire WL, Clark GM: Prognostic factors and treatment decisions in axillary-node-negative breast cancer.N Engl J Med 326:1756-1761, 1992.

  6. 7)

    Rosen PP, Groshen S, Saigo PE,et al: Pathological prognostic factors in stage I (T1N0M0) and stage II (T1N1M0) breast carcinoma; A study of 644 patients with median follow-up of 18 years.J. Clin Oncol 7: 1239–1251, 1989.

  7. 8)

    Rosen PP, Groshen S, Saigo PE,et al: A long-term follow-up study of survival in stage I (TlNlMO)and stage II (T1N1M0) breast carcinoma.J Clin Oncol 7:355–366, 1989.

  8. 9)

    Bloom HJ, Richardson WW: Histological grading and prognosis in breast cancer.Br J Cancer 11:359–377, 1957.

  9. 10)

    Scarff RW, Torioni H: Histological Typing of Breast Tumors, WHO, Geneve, ppl3–20, 1968.

  10. 11)

    Fisher ER, Redmond C, Fisher B: Histologic grading of breast cancer.Pathol Ann 15:239–251, 1980.

  11. 12)

    Henson DE: The histological grading of neoplasms.Arch Pathol Lab Med 112:1091–1096, 1988.

  12. 13)

    Knight WA III, Livingston RB, Gregory EJ,et al: Estrogen receptor as an independent prognostic factor for early recurrence in breast cancer.Cancer Res 37:4669–4671, 1977.

  13. 14)

    Clark GM, McGuire WL: Steroid receptors and other prognostic factors in primary breast cancer.Semin Oncol 15:20–25, 1988.

  14. 15)

    Nomura Y, Miura S, Koyama H,et al: Relative effect of steroid hormone receptors on the prognosis of patients with operable breast cancer.Cancer 69: 153–164, 1992.

  15. 16)

    Horowitz KB, McGuire WL, Pearson OH,et al: Predicting response to endocrine therapy in human breast cancer; A hypothesis.Science 189:726–727, 1975.

  16. 17)

    Kinsel LB, Szabo E, Greene GL,et al: Immunocyto-chemical analysis of estrogen receptors as a predictor of prognosis in breast cancer patients; Comparison with quantitative biochemical methods.Cancer Res 49:1052–1056, 1989.

  17. 18)

    Berger U, Wilson P, Thethi S,et al: Comparison of an immunocytochemical assay for progesterone receptor with a biochemical method of measurement and immunocytochemical examination of the relationship between progesterone and estrogen receptors.Cancer Res 49:5176–5179, 1989.

  18. 19)

    Foekens JA, Portengen H, van Putten WLJ,et al: Prognostic value of estrogen and progesterone receptors measured by enzyme immunoassays in human breast tumor cytosols.Cancer Res 49:5823–5828,1989.

  19. 20)

    Andersen J, Thorpe SM, King W,et al: The prognostic value of immunohistochemical estrogen receptor analysis in paraffin-embedded and frozen sections versus that of steroid-binding assays.Eur J Cancer 26:442–449, 1990.

  20. 21)

    Wenger CR, Beardslee S, Owens MA,et al: DNA ploidy, S-phase and steroid receptors in more than 127,000 breast cancer patients.Breast Cancer Res Treat 28:9–20, 1993.

  21. 22)

    Hedley DW, Clark GM, Cornelisse CJ,et al: Consensus review of the clinical utility of DNA cytometry in carcinoma of the breast.Cytometry 14:482–485, 1993.

  22. 23)

    Remvikos Y, Beuzeboc P, Zajdela A,et al: Correlation of pretreatment proliferative activity of breast cancer with the response to cytotoxic chemotherapy.J Natl Cancer Inst 81:1383–1387, 1989.

  23. 24)

    Dressier LG, Eudey L, Gray R,et al: Prognostic potential of DNA flow cytometry measurement in node-negative breast cancer patients; Preliminary analysis of an Intergroup study (INT0076).J Natl Cancer Inst Monogr 11:167–172, 1992.

  24. 25)

    Zambetti M, Bonadonna G, Valagussa P,et al: Adjuvant CMF for node-negative and estrogen receptor-negative breast cancer patients.J Natl Cancer Inst Monogr 11:77–83, 1992.

  25. 26)

    Muss HB, Thor AD, Berry DA,et al:c-erbB-2 expression and response to adjuvant therapy in women with node-positive breast cancer.N Engl J Med 330:1260–1266, 1994.

  26. 27)

    Legros Y, Lacabanne V, d’Agay MF,et al: Production of human p53 specific monoclonal antibodies and their use in immunohistochemical studies of tumor cells.Bull Cancer 80:102–110, 1993.

  27. 28)

    Elledge RM, Clark GM, Fuqua SAW,et al: p53 protein accumulation detected by five different antibodies; Relationship to prognosis and heat shock protein 70 in breast cancer.Cancer Res 54:3752–3757, 1994.

  28. 29)

    Isola J, Visakori T, Holli K,et al: Association of overexpression of tumor suppressor protein p53 with rapid cell proliferation and poor prognosis in node-negative breast cancer patients.J Natl Cancer Inst 84:1109–1114, 1992.

  29. 30)

    Allred DC, Clark GM, Elledge R,et al: Association of p53 protein expression with tumor cell proliferation rate and clinical outcome in node-negative breast cancer.J Natl Cancer Inst 85:200–206, 1993.

  30. 31)

    Silvestrini R, Benini E, Daidone MG,et al: p53 as an independent prognostic marker in lymph node-negative breast cancer patients.J Natl Cancer Inst 85:965–970, 1993.

  31. 32)

    Radvin PM, Chamness GC: Thec-erbB-2 protooncogene as a prognostic and predictive marker in breast cancer; A paradigm for the development of other macromolecule markers.Gene 159:19–27, 1995.

  32. 33)

    Têtu B, Brisson J: Prognostic significance of HER-2/ neu oncoprotein expression in node-positive breast cancer; The influence of the pattern of immunostain-ing and adjuvant therapy.Cancer 73:2359–2365, 1994.

  33. 34)

    Allred DC, Clark GM, Tandon AK,et al: UER-2in node-negative breast cancer; Prognostic significance of overexpression influenced by the presence of in situ carcinoma.J Clin Oncol 10:599–605, 1992.

  34. 35)

    Gusterson BA, Gelber RD, Goldhirsch A,et al: Prognostic importance of c-erbB-2 expression in breast cancer; International (Ludwig) Breast Cancer Study Group.J Clin Oncol 10:1049–1056, 1992.

  35. 36)

    Benz CC, Scott GK, Sarup JC,et al: Estrogen-dependent, tamoxifen-resistant tumorigenic growth of MCF-7 cells transfected with HER2/neu.Breast Cancer Res Treat 24:85–95, 1992.

  36. 37)

    Wright C, Nicholson S, Angus B,et al: Relationship between c-erbB-2 protein product expression and response to endocrine therapy in advanced breast cancer.Br J Cancer 65:118–121, 1992.

  37. 38)

    Ravdin PM: Evaluation of cathepsin D as a prognostic factor in breast cancer.Breast Cancer Res Treat 24:219–226, 1993.

  38. 39)

    Tetu Brisson J, Cote C,et al: Prognostic significance of cathepsin-D expression in node-positive breast carcinoma; An immunohistochemical study.Int J Cancer 55:429–435, 1993.

  39. 40)

    Johnson MD, Torri JA, Lippman ME,et al: The role of cathepsin D in the invasiveness of human breast cancer cells.Cancer Res 53:873–877, 1993.

Download references

Author information

Correspondence to Gary M. Clark.

Additional information

Supported in part by grants CA30195, CA58183, CA54174 from the National Cancer Institute.

About this article

Cite this article

Clark, G.M. Prognostic and predictive factors for breast cancer. Breast Cancer 2, 79 (1995).

Download citation

Key words

  • Breast cancer
  • Prognostic factors
  • Predictive factors
  • Survival