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Prognostic factors in breast cancer - College of American Pathologists Consensus Statement 1999
Author(s): Fitzgibbons PL, Page DL, Weaver D, Thor AD, Allred C, Clark GM, Ruby SC, O'Malley F, Sinpson LF, Connolly JL, Hayes DF, Edge SB, Lichter A, Schnitt SJ
Source: ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE    Volume: 124    Issue: 7    Pages: 966-978    Published: JUL 2000  
Times Cited: 413     References: 165     
Abstract: Background.-Under the auspices of the College of American Pathologists, a multidisciplinary group of clinicians, pathologists, and statisticians considered prognostic and predictive factors in breast cancer and stratified them into categories reflecting the strength of published evidence.

Materials and Methods.-Factors were ranked according to previously established College of American Pathologists categorical rankings: category I, factors proven to be of prognostic import and useful in clinical patient management; category II, factors that had been extensively studied biologically and clinically, but whose import remains to be validated in statistically robust studies; and category III, all other factors not sufficiently studied to demonstrate their prognostic value. Factors in categories I and II were considered with respect to variations in methods of analysis, interpretation of findings, reporting of data, and statistical evaluation. For each factor, detailed recommendations for improvement were made. Recommendations were based on the following aims: (1) increasing uniformity and completeness of pathologic evaluation of tumor specimens, (2) enhancing the quality of data collected about existing prognostic factors, and (3) improving patient care.

Results and Conclusions.-Factors ranked in category I included TNM staging information, histologic grade, histologic type, mitotic figure counts, and hormone receptor status. Category II factors included c-erbB-2 (Her2-neu), proliferation markers, lymphatic and vascular channel invasion, and p53. Factors in category Ill included DNA ploidy analysis, microvessel density, epidermal growth factor receptor, transforming growth factor-alpha, bcl-2, pS2, and cathepsin D. This report constitutes a detailed outline of the findings and recommendations of the consensus conference group, organized according to structural guidelines as defined.

Document Type: Proceedings Paper
Language: English
Reprint Address: Fitzgibbons, PL (reprint author), Hosp Good Samaritan, Dept Pathol, 1225 Wilshire Blvd, Los Angeles, CA 90017 USA
Addresses:
1. Hosp Good Samaritan, Dept Pathol, Los Angeles, CA 90017 USA
2. Vanderbilt Univ, Med Ctr, Nashville, TN USA
3. Univ Vermont, Med Ctr, Burlington, VT USA
4. Northwestern Univ, Evanston Hosp, Evanston, IL 60201 USA
5. Baylor Coll Med, Houston, TX 77030 USA
6. Palos Community Hosp, Palos Hts, IL USA
7. Mt Sinai Hosp, Toronto, ON M5G 1X5 Canada
8. Beth Israel Hosp, Boston, MA 02215 USA
9. Georgetown Univ, Med Ctr, Washington, DC 20007 USA
10. Roswell Pk Canc Ctr, Buffalo, NY USA
11. Univ Michigan, Ann Arbor, MI 48109 USA
Publisher: COLLEGE AMER PATHOLOGISTS, C/O KIMBERLY GACKI, 325 WAUKEGAN RD, NORTHFIELD, IL 60093-2750 USA
Subject Category: Medical Laboratory Technology; Medicine, Research & Experimental; Pathology
IDS Number: 334HK
ISSN: 0003-9985
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