Factores pronósticos morfológicos determinantes en las metástasis a distancia en los carcinomas mamarios infiltrantes

Introduction: Distant metastasis reduces the survival of patients with infiltrating breast carcinomas and it is necessary to detect determining prognostic factors in their appearance. Objective: to identify morphological prognostic factors with predictive capacity for distant metastasis. Methods: a prospective longitudinal observational study was conducted in a sample of 333 patients diagnosed with infiltrating breast carcinomas in a period of 16 years. Size and tumor volume, multicentricity, multifocality, lymph node status, extracapsular or periganglionar infiltration, Berg´s ganglionar levels, histological subtype and grade, border and tumor necrosis, inflammatory response, lymphatic vascular invasion, intraductal component and surgical resection margins, were the variables. Survival analysis was performed for all variables by the Kaplan-Meier method in relation to distant metastases and the Log-Rank test was applied, comparisons in the subgroups of each variable were established to identify possible predictors. Results: of a 333 total patients, 59 presented distant metastasis with a 14.49 years average of presentation. Periganglionar infiltration, (p 125cm3, histological subtypes ductal-lobular infiltrating, epidermoid and apocrine metaplastic, histological grade 3 and its components mitotic count >22 mitoses in 10 higher increase areas and nuclear pleomorphism 3 were very significant, and (0.005≤p<0.05), lymphovascular invasion, T3 and necrosis were significant. Conclusions: the morphological prognostic factors that were the best predictors of distant disease-free survival, were ganglionar state, periganglionar infiltration, Berg´s ganglionar levels, tumor volume, histological subtype and grade.