Although other studies also reported that TN could predict survival, they believed that this effect was not independent of other high-risk pathological characteristics. also believed that the presence of TN was an independent predictor for overall survival and metastasis-free survival. Being consistent with this result, Vincent-Salomon et al. The presence of TN was an independent predictor for early recurrence (0 to 2 years after diagnosis) and for survival in the overall 10-year follow-up period. found that the presence of TN was significantly associated with aggressive tumor characteristics including age, lymph nodes and tumor size. Based on presence/absence classification, Gilchrist et al. However, there were several conflicting results about the impact of TN on IBC prognosis. The relationship between TN and invasive breast cancer (IBC) outcome has also been widely studied through these two necrotic classification methods. As a kind of solid tumor, breast cancer was the most commonly diagnosed cancer.
In these studies, classifications based on a presence/absence basis and extent basis were traditionally applied, and the association between TN and poor outcome was found. It is a common histological feature of solid tumors, and its prognostic significance has been studied in several solid tumors. Tumor necrosis (TN) is histologically characterized by homogeneous clusters and sheets of dead and degraded tumor cells that coalesce into an amorphous coagulum, which are admixed with nuclear and cytoplasmic debris. Incorporating TN-score into staging category could improve its performance to stratify patients. High-risk TN “up-staged” the patients with IBC. Only high-risk TN was associated with poor prognosis. TN-score was an independent prognostic factor for 5-year DFS. 66.3% P = 0.856 in validation set), as well as patients with high-risk TN and stage II tumors had a 5-year DFS comparable to patients with stage III tumors (33.3% vs. Patients with high-risk TN and stage I tumors had a 5-year DFS comparable to patients with stage II tumors (55.6% vs. Furthermore, high-risk TN “up-staged” the patients with IBC. 70.8% P = 0.017 in validation set), while patients with low-risk TN had a 5-year DFS comparable to patients with no necrosis (60.0% vs. Patients with high-risk TN had worse 5-year disease-free survival (DFS) than patients with no necrosis (32.5% vs. Based on the frequency of individual TN, TN-score was obtained to investigate the prognostic value of TN. According to the relative spatial positions of TN, tumor cells, collagen fibers and myoepithelium, four spatial heterogeneities of TN (TN1-4) were defined. Multiphoton microscopy (MPM) was used to obtain multiphoton images from 471 patients.
The purpose of this study was to propose a new method to reveal the hidden prognostic value of spatial heterogeneity of TN in invasive breast cancer (IBC).
However, the traditional classification of TN ignored spatial intratumor heterogeneity, which may be associated with important prognosis. Tumor necrosis (TN) was associated with poor prognosis.
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