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Prognostic Variables and Future Predictors of Behaviour and Response

  • Conference paper
Adjuvant Therapy of Breast Cancer V

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 140))

  • 59 Accesses

Abstract

Recent reviews have clearly defined the present role of prognostic factors in the management of breast cancer (Levine et al. 1991; McGuire 1991; Osborne 1992; Clark 1994; Clark et al. 1994; Gusterson 1995). As adjuvant therapy has become generally used there has been a decreased need for prognostic factors to aid in the optimisation of treatment. It is now accepted that the main application for prognostic factors is to identify those patients who have such a good prognosis that they can be spared any form of adjuvant treatment (Clark 1994). As stated by Page (1991), the “modern” markers of prognosis, based on our understanding of the normal cell cycle and the molecular abnormalities in breast cancer, offer little additional information over and above that of the gold standard, which is a good pathologist with a haematoxylin and eosin section. Thus tumour grade, size of the tumor and lymph node status are the parameters against which everything else should be measured (Fisher et al. 1978; Fisher 1986). S-phase fraction is an objective method of measuring tumour proliferation, but standardisation is still a problem for comparisons between centres. Vascular invasion and angiogenesis (Horak et al. 1992) are recent additions, as predictors of latent metastatic disease. Similarly bone marrow (Cote et al. 1991; Mansi et al. 1991; Neville et al. 1992) and lymph node micrometastases (de Mascarel et al. 1992; International Breast Cancer Study Group 1990) are indicators of tumour burden and thus predictors of relapse. The practical significance of such measurements is, however, unclear as it is not possible to predict relapse and the time of relapse for individual patients based on these measurements.

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Authors and Affiliations

  1. Haddow Laboratories, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey, SM2 5NG, UK

    B. A. Gusterson

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  1. B. A. Gusterson
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Editors and Affiliations

  1. Department of Medicine C, Kantonsspital, CH-9007, St. Gallen, Switzerland

    Hans Jörg Senn  & Beat Thürlimann  & 

  2. Division of Biostatistics, Dana Farber Cancer Institute, 44, Binney Street, 02115, Boston, MA, USA

    Richard D. Gelber Ph.D.

  3. Ospedale Civico, CH-6900, Lugano, Switzerland

    Aron Goldhirsch

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© 1996 Springer-Verlag Berlin Heidelberg

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Gusterson, B.A. (1996). Prognostic Variables and Future Predictors of Behaviour and Response. In: Senn, H.J., Gelber, R.D., Goldhirsch, A., Thürlimann, B. (eds) Adjuvant Therapy of Breast Cancer V. Recent Results in Cancer Research, vol 140. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79278-6_11

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  • DOI: https://doi.org/10.1007/978-3-642-79278-6_11

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