Clinical and immunohistochemical prognostic factors, classifiers and determining adverse events in distant metastases in infiltrating mammary carcinomas

Abstract

Introduction: The healing of distant metastases, once they occur, is unlikely, although long-term remissions and palliation can be achieved. During the anatomopathological diagnosis, the identification of the determining prognostic factors in their probable appearance is essential, since survival will depend on this. Objective: To identify the clinical prognostic factors, immunohistochemical factors, classifiers and adverse events with predictive capacity for distant metastasis. Methods: A prospective longitudinal observational study was conducted in a sample of 333 patients with a diagnosis of infiltrating mammary carcinomas over a period of 16 years. The variables were grouped into clinical, immunohistochemical, classifiers and adverse events (local relapse). Survival analysis was performed by the Kaplan-Meier method in relation to distant metastases, and the comparisons were made with the Logrank technique in the subgroups of each variable to identify the best predictors. Results: The very significant variables (p<0.005) were overexpression of p53; the group >5.4 of the Nottingham prognostic index, stages IIIC and IV, the N3 and M1 classification of TNMp and the local relapse and the significant ones (0.005≤p<0.05) were the bilaterality and negativity of Bcl2. Conclusions: The predictive factors for distant metastasis were bilaterality, p53 and Bcl2, Nottingham prognostic index, stage, N and M classification of TNMp and local relapse. It was demonstrated that factors of the clinical pathological and molecular levels are involved in the probability of appearance of metastases.