Relationship of pathologic and some clinical discriniinants to the spread of breast cancer

Breast cancer, Pathologic discriminants breast cancer, Clinical discriminants breast cancer. Spread breast cancer, Lymph nodes breast cancer, Metastases breast cancer. The conventional view regarding the natural history of breast cancer indicates that the primary tumor spreads to the regional lymph nodes at some given time(s) and subsequently disseminates systemically with further time. The significance of the time factor in this scheme at present is polemical. This concept also ascribes a primary role to lymphatic extension in the spread of the disease. Experimental studies which have demonstrated that tumor cells traverse lymph nodes’ and thus gain access into the general circulation tend to support such a contention. Yet, it is surprising that little attention has been directed to the phenomenon of direct neoplastic venous extension. That such an event occurs might be deduced from the, albeit rare, histopathological evidence of intravascular extension’* as well as from the presence of tumor cells in venous tributaries draining breast cancers in about 0.25 of a small series of cases.” This latter phenomenon was noted with equal frequency in both pathologic Stage I and II cases. Nevertheless, it has been demonstrated repeatedly that regional nodal metastases represent an ominous prognostic discriminant for breast cancer. Indeed, a prevalent view regards nodal metastases as an index of systemic spread. It readily becomes apparent that identification of factors which might influence or reflect the nodal status of patients with breast cancer might provide some insight into the mechanism as well as significance of such an event. Accumulating evidence of decreasing treatment failure rates with the use of adjuvant chemotherapy in patients with Stage II disease indicates the pragmatic value of such information.5*9.” In this communication we shall attempt to identify those pathological and clinical characteristics that were found to be associated with lymph node metastases and treatment failure rates [% failure/(average months followed)] in patients with invasive, operable mammary cancer (clinical Stages I and II) entered in the National Surgical Breast Project, protocol No. 4. These women were randomized prospectively so that those with clinically negative axillae were treated by radical mastectomy or total (simple) mastectomy with or without postoperative irradiation. Those with clinically positive axillae also were randomized and received either radical mastectomy or total mastectomy and irradiation. Information relating to nodal involvement is based upon the 386 patients of the first 1000 entered that were subjected to radical mastectomy regardless of clinical nodal status. These patients were categorized according to whether pathological examination of their axillary nodes revealed 1-3, 4 or more, or no nodal metastases. This stratification was derived from previous studies which indicated that the number rather than proportion of involved nodes were significantly related to survival.” Associations with treatment failure rates were compiled from information obtained from all arms of the study constituting 1665 patients. Treatment failure is defined as the occurrence of local or regional recurrence or systemic metastases or death resulting from breast cancer. The average period of