Comparison of four methods to assess proliferative activity in breast carcinoma

Abstract EN

Proliferative activity is an important prognostic marker in breast carcinoma.

However, the best measurement method has not been established.

This study was performed to compare the different proliferative markers in breast carcinoma and to define the most suitable one for daily routine use in our surgical pathology laboratories.

Four methods of estimating proliferative activity of 50 cases of primary invasive breast carcinomas were compared: mitosis per 10 high power field (MFC), mitosis per 1.000 tumour cells (MFI), ki-67 immunostaining and detection of nucleolar organizer regions (NORs) by silver stain.

All methods were done on paraffin embedded materials.

Statistical analysis of the results showed highly significant correlation between the four methods of estimating proliferative activity.

The strongest correlation was observed between MFC and MFI.

Histological tumour grade and axillary lymph node status are two important prognostic factors in breast carcinoma.

The grade was strongly correlated with 4 methods of estimating proliferative activity.

Mitotic figure count (MFC) was the only method associated with the presence or absence of axillary lymph node metastasis.

In conclusion, in surgical pathology laboratories that cannot afford the cost of immunohistochemistry, mitotic figure count (MFC) can provide an estimation of proliferation fraction close to ki-67 immunostaining.