Dear Altig,
We still do flow on breast cancer patients. Most all patients have ploidy
and we report S% in about 75% of the cases. The 25% of the cases have various
problems such as overlap of data, poor histograms, or not enough cells. We have
incorporated MIB-1 staining to each patient. The pathologist reports the
percent of MIB-1 positive tumor cells present (i.e.. 25% positive tumor cells)
and we have a positive control fro every sample on the same slide. The
pathologist usually looks for a representative spot but more than likely he will
look for a "hot spot" with staining and then count fields. This is a tedious
procedure but I believe that it represents the best semi automated method.
There are companies that have automated analysis programs but they are expensive
and time consuming. We report the actual percent and then we report how this
relates to the standardized distribution of breast cancer patients which have
been divided into 5 groups. These groups are 0%, 1-4%. 5-20%, 21 to 40%, and
>40%. We define the first two groups as low, the middle group as moderate and
the last two groups as high. Currently, we are going back now and trying to
relate our results to the outcome. This again is a tedious procedure but we
feel that both flow cytometry and immunohistochemistry for MIB-1 gives the
oncologist an idea of proliferative activity for the patient.
Dr. Kute
"Altig,Kathy" wrote:
> This is a question for the Clinical people involved in breast cancer
> prognostic indicators:
>
> What methods are your labs using for an indication of proliferate rate for
> breast cancer. We have done (and are still currently doing) DNA ploidy and
> S-phase analysis. This is a logistical headache, and no longer the method
> of choice for many labs. So - for those of you no longer doing DNA
> analysis....what are you doing? Immunohistochemistry? MIB-1? Ki-67 by
> flow? ...by immuno ? If by immunohistochemistry, who does the counting? Do
> you give the clinician a hard number? What kind of numbers do you turn out?
> What kind of study (cut offs) did you do to come up with ranges?
>
> Thank you.
> Kathy Altig
> Southwest Washington Medical Center
> Vancouver, WA
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