The prognosis and selection of therapy are influenced by the size, type and stage of the cancer, the microscopic appearance and tumor grade, the involvement of axillary lymph nodes and the number of nodes involved, and the woman's age and her menopausal status (natural or surgically induced) at the time of diagnosis. The larger the cancer, the more likely it has spread to axillary lymph nodes and metastasized.
They are also influenced by several other increasingly important prognostic factors. These tests offer predictive information about the risk of recurrence or metastasis . This may make it possible to identify women with a worse prognosis who should be offered earlier and/or more aggressive therapy. Prognostic markers also help oncologists tailor the most appropriate forms of adjuvant chemotherapy to each individual. These tumor tissue tests include:
• The measurement of protein receptors for two types of female hormones that affect breast cancer tissue
estrogen and progesterone . The tumor content of these receptors—positive or negative—correlates with
prognosis and response to hormonal therapy.
• Flow cytometry for analysis of the tumor's DNA content. The average amount of cellular DNA in the
chromosomes of the tumor—DNA ploidy—strongly correlates with the cancer's aggressive activity. Poorly
differentiated tumors tend to have abnormal DNA content (aneuploid), and patients with these tumors will not
generally do as well as those whose tumors have the correct amount of chromosomal DNA (diploid).
