A study on clinical courses of breast cancer having a poor correlation with prognostic factors

Of a total of 1,051 cases of primary breast cancer operated on in the Shikoku Natioal Cancer Center Hospital during a period of 20 years from 1967 through 1986, those cases of discord between prognostic factors for breast cancer (histological lymphnodal metastasis and tumor size) and the clinical course were clinicopathologically examined with respect to other factors. Of 504 n₀ cases (excepting cases of T₄) with presumed good prognosis. 60 cases of recurrence (n_o recurrent group) were examined comparatively with 448 cases of the n₀ non-recurrent group. Of 194 cases comprising those of a high degree of lymphonodal metastasis (more than 8 points of axillary lymphonodal metastasis or positive subclavian lymphnodal metastasis) and those of T₄, 61 cases without recurrence for more than 3 years (non-recurrent advanced cancer group) were examined comparatively with 133 cases of the recurrent advanced cancer group. The following results were obtained. Compared with the non-recurrent group, the n₀ recurrent group showed, at a high frequency, pathohistological prognostic factors (histological type, degree of spreading, degree of heteromorphism, mode of infiltrating proliferation, degree of lymphatic invasion) of a high degree of malignancy, suggesting necessary postoperative supplementary therapy for such cases of even n₀. For cases of advanced cancer, no definite difference in pathohistological factors was observed between both these groups, making it impossible to extract these factors. This was regarded as being ascribable to the effect of the positive supplementary therapy including preoperative arterial infusion.