In a retrospective study on cytological specimens from 86 patients with histologically confirmed invasive breast cancer, the prognostic value of nucleolar morphometric variables was studied and compared with nuclear variables. One hundred nuclei and their nucleoli on each slide were measured with a graphic tablet system at a total magnification of 2800 times using a stratified selection method. The number of nucleoli per 100 nuclei was also noted. Analysis of Kaplan-Meier univariate recurrence free survival curves showed significant differences for eight nuclear features, nine nucleolar features, and three combined nuclear and nucleolar variables. The total number of nucleoli per 100 nuclei was the best single prognostic variable. Multivariate survival analysis (Cox regression model) showed that no other features provided additional prognostic information beyond that given by the total number of nucleoli. It is concluded that nucleolar morphometric variables assessed in cytological preparations have prognostic value in breast cancer, and the results of this study suggest that their prognostic value may exceed that of nuclear variables.
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