Mitotic Actvity Index IDs High-Risk Node-negative Breast Cancer

-The mitotic activity index has been shown to be an independent prognostic factor for recurrence-free survival in breast cancer.
-It is being used in the Netherlands to select which node-negative patients require adjuvant chemotherapy.
-Dr. van der Wall presented the results of an 8-year follow-up of 586 premenopausal node-negative patients from the Multicenter Mammary Carcinoma Project and found suprising results.

The Dutch Society for Medical Oncology on Adjuvant Chemotherapy recommended that adjuvant chemotherapy be given only to high-risk patients, defined as those women who have an MAI equal to or greater than 10 (in an area of 1.6 mm2). Low-risk patients, defined as those with a tumor size of 1 to 3 cm and an MAI less than 10, are not recommended for adjuvant chemotherapy. The study results that Dr. Van der Wall got from the Free University Hospital was that

Study Results

Dr. van der Wall presented the results of an 8-year follow-up of 586 premenopausal node-negative patients from the Multicenter Mammary Carcinoma Project of the Department of Pathology at the Free University Hospital. The project was designed to prospectively evaluate the prognostic value of various features in 3,479 patients with invasive breast cancer.

None of the 586 patients received adjuvant chemotherapy. Eighty-five patients (14.5%) died of metastatic disease during the follow-up. The deaths were not evenly distributed among patients with low and high MAI, however.

Only 19 (6.1%) of 310 patients with a low MAI (less than 10) died of metastatic disease, compared with 66 (28.3%) of 233 patients with a high MAI (10 or more). The survival of patients with low MAI was comparably high in all subgroups, including patients with different tumor diameters and grades and differences in estrogen-receptor and proges-terone-receptor status.


By: Oncology News International
Title: Mitotic Actvity Index IDs High-Risk Node-negative Breast Cancer
Source: Volume 10, Number 3
Publication date: March 1, 2001
Date Accessed: May 18,2010
URL: http://www.cancernetwork.com/display/article/10165/65883