Purpose: Despite the fact that the primary factor to determine the
prognosis of breast cancer is the metastatic lesion rather than the primary
tumor, most studies concerning the prognostic factors related with tumoric
biological behavior have focused on the primary tumors. A better
understanding of changes of biological behavior in the metastatic lesions
will provide a clue to more effective and rational approaches for treating
metastatic breast cancer. Methods: This study was designed to
investigate the biological characteristics of metastatic cancer cells in
breast cancer and to compare them to those of the primary tumors. Eighty-two
breast cancer patients with metastatic axillary lymph nodes were selected
for study. The evaluated tumoric biological characteristics used in this
study were histologic grade, estrogen receptor, progesterone receptor,
bcl-2, c- erbB2, p53, and P-glycoprotein. Evaluations were carried out with
H-E and immunohistochemical stainings. The subjects were divided into
positive cases and negative cases, according to extent and degree of
staining. McNemar’s test and Spearman’s rho correlation coefficient were
used for statistical analysis and cases showing a p-value of 0.05 or less
were taken as being statistically significant. Results: The results
were as follows: 1) Metastatic nodes showed higher histologic grade than
primary tumors. 2) No significant pattern was observed concerning changes in
biological characteristics, including estrogen receptor, progesterone
receptor, bcl-2, c-erbB2, p53, and P-glycoprotein between primary tumor and
metastatic lymph nodes. 3) Neither wea any significant difference observed
in biological behavior among the metastatic lymph nodes. Conclusion:
This results indicate that the meaningful biological characteristic of
metastatic lesion is higher histologic grade alone, and suggest that this
change in histologic grade is the single, specific factor determineing the
prognosis for metastatic breast cancer.
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