Impact of tumor grade and host resistance on survival of women with breast cancer

Abstract

While efforts to produce a more accurate and more widely accepted system of clinical staging for breast cancer are to be encouraged, this parameter reveals nothing of the tempo of the disease, nor of the likely presence of occult metastases in apparently early cases, nor the possible existence of host resistance. The continued study of inhomogeneous case groups in breast cancer may obscure any small advantage of a particular treatment for a certain type of case, and this may explain some of the current difficulties in interpreting treatment results. A series of 1,411 cases of breast cancer, with a potential follow-up of 20 years, has been used to demonstrate the role of morphological factors relating to tumor malignancy and to host resistance in assessing more accurately prognosis and the value of various treatments. Within, for example, clinical Stage 3 the corrected 10-year survival rate varied from 53% for Grade I cases to 12% for Grade III cases. The corrected 20-year survival rate for women with Stage I, Grade III breast cancer was 94% for those with medullary tumors, compared with 39% for those with all other types of breast cancer within the same stage and grade; in Stage 2 the difference was also striking—50% compared with 5%. Axillary dissection and postoperative radiotherapy was not harmful in women with early tumors showing histologic evidence of high host resistance, the cure rate for such cases being virtually 100%.