Grading and prognosis of infiltrating ductal breast carcinoma by mean nuclear volume estimates.

OBJECTIVE

Quantitative evaluation of nuclear size in breast cancer is performed with the aim of investigating whether the data obtained are related to subjective grading and prognosis.

STUDY DESIGN

Unbiased stereologic estimates of the volume-weighted mean nuclear volume (nuclear vv) in paraffin-embedded tissue from 44 specimens of infiltrating ductal breast carcinoma were obtained by the point-sampled intercepts method.

RESULTS

Histologically graded cases showed an overlap in nuclear vv estimates, but significant differences were demonstrated in which averaged values increased from grade 1 to 3 breast carcinomas. Nuclear vv estimates in grade 3 breast carcinoma (mean, 495.4 microns 3; SD, 101.7 microns 3) were significantly larger than those in grades 1 (mean, 327.8 microns 3; SD, 90.9 microns 3) and 2 (mean, 409.9 microns 3; SD, 72.6 microns 3) (P < .01). Minor statistically significant differences (P < .05) were found between grades 1 and 2. Estimates of nuclear vv based on systematic sampling within the specimen showed high efficiency, with > 80% of the total observed variance contributing to biologic differences between individual specimens. Univariate prognostic study showed that clinical stage, and not histologic grade, was of prognostic value in the cases studied. Similarly, nuclear vv estimates were associated with disease recurrence and survival, with a cutoff point of 425 microns 3.

CONCLUSION

Based on the cases investigated, shape-independent nuclear vv estimates may be an adjuvant tool in the grading and prognostic evaluation of infiltrating ductal breast carcinoma.