Fibrosis as an Indication of Time in Infiltrating Breast Cancer and its Importance in Prognosis

The histological grading of tumours according to their intrinsic malignancy is very important in the prognosis of breast cancer but within each grade the ultimate prognosis depends mainly on the age of the tumours. We have shown that tumour fibrosis is an indication of this time factor, increasing with the age of the tumour. Within each grade the metastatic ratio is higher and the 5 year and 10 year survival less with the scirrhous than with the non-scirrhous tumours. The establishment of axillary metastases is closely connected with both the degree of malignancy and the time available, the unfavourable effect upon survival being greater in the scirrhous than in the non-scirrhous tumours. Another consequence of the passage of time, as indicated by fibrosis, is the gradual diminution of lymphoid infiltration (LI) which is mostly present in young tumours, especially those of high grades. The favourable effect of LI upon survival is demonstrated in the non-scirrhous tumours of grade III, possibly because of its great intensity, but this influence upon survival is lost as fibrosis increases and the intensity of the reaction diminishes.