|
|
|
|
|
|
|
| MPI
and MPA Index |
| |
|
MORPHOMETRIC PROGNOSTIC INDEX (MPI)
and MITOTIC ACTIVITY INDEX (MAI) |
Study #1
Survival data on 211 premenopausal mastectomy
patients 1969-1980
(all treated by modified radical mastectomy...those with central
or medial primaries or with positive nodes also getting radiation) |
Who needs early adjuvant chemotherapy (ACT)? |
|
node-negative group |
|
RFSrelapse/recurrence-free survival (5
years) |
overall survival
(5 years) |
| MPI less than 0.60 |
83% (n=87 cases) |
94% |
| MPI greater than 0.60 |
53% (n=34 cases) |
65% |
| MPI greater than 0.0 |
58% (n=60 cases) |
77% |
| MPI less than 0.0 |
90% (n=60 cases) |
97%
(don't need ACT?) |
| MAI less than 10 |
94% (n=65 cases) |
97%
(don't need ACT?) |
| MAI greater than 10 |
63% n=56 cases) |
73% |
|
node-positive group |
|
RFSrelapse/recurrence-free
survival (5 years)
|
overall survival
(5 years)
|
| MPI less than 0.60 |
60% n=30 cases) |
80% |
| MPI greater than 0.60 |
28% (n=60 cases) |
45% |
| MPI greater than 0.0 |
35% (n=83 cases) |
54% |
| MPI less than 0.0 |
86% (n=7 cases) |
86% |
| MAI less than 10 |
63% (n=40 cases) |
78% |
| MAI greater than 10 |
34% (n=50 cases) |
40% |
Reference: Baak, JPA, et. al., Human Pathology 22:326-336, 1991
|
Study #2
Special group of axillary
lymph node positive patients with an improved prognosis
(Eastern Cooperative Oncology Group
Companion Study EST 4189): |
-
368 eligible patients (in a total group of 560)
-
if MAI 0-2 mitoses per 10 40x hpfs, 5 year recurrence
rate only 31% (RFS of 69%...a 6% advantage over MAI <10),
as compared to:
-
if MAI greater than 2, 5 year recurrence rate is
52% (RFS of 48%)
Reference: David Page, et. al., Vanderbilt U. Dept. Pathology;
J. Clin. Oncol. 18(10):2059-2069; May 2000.
|
From 23rd Annual San Antonio Breast Conference
6-9 Dec. 2000
-
Node negative, premenopausal: 543 patients without
chemo, 8 yr follow-up
-
Conclusion: the expected gain in lives
saved is greatest in those node-negative cases with MAI >10
who are treated with ACT(adjuvant chemotherapy).
|
|
|
© Copyright
1999 - 2006, all rights reserved, Pathology Associates Of Lexington,
P.A. |
| |
