Scattered fat invasion: An indicator for poor prognosis in premenopausal, and for positive estrogen receptor in postmenopausal breast cancer patients

Background: Intracrine mechanisms which accelerate cancer cell growth are becoming well known in breast cancer research. In this study, microscopic invasive patterns of breast cancer cells into surrounding stromal tissues were evaluated. Patients and Methods: 174 patients (110 patients less than or equal to 50, and 64 greater than or equal to 60 years) underwent total or partial mastectomy from 1985 to 1993, In these patients the microscopic invasive pattern (especially scattered invasion into fat, SIF), influence on hormone receptor status, survival, and adjuvant therapy effectiveness were studied. Results: A correlation was shown between being SIF- and estrogen receptor-positive only in older (greater than or equal to 60 years) patients (chi (2) test, p = 0.058). In younger patients, SIF was also related to a poorer prognosis (log rank test, p = 0.0004). These results were also confirmed by multivariate analysis. Adjuvant therapy activity was influenced by SIF status in premenopausal patients. Conclusion: In older patients, SIF may be related to an intracrine supply of estrogen. In younger patients, SIF seems to work by a different mechanism for survival. These results also suggest some influence of SIF on adjuvant chemo-endocrine therapy results. Copyright (C) 2000 S. Karger AG, Basel.