NODE-POSITIVE BREAST-CANCER - PROGNOSTIC-SIGNIFICANCE OF THE PLASMA PROLACTIN COMPARED WITH STEROID-RECEPTORS AND CLINICOPATHOLOGICAL FEATURES

: The value of plasma prolactin (PRL), estrogen-receptor (ER) and progesterone-receptor (PR) determinations in predicting overall survival was evaluated in a group of 151 breast cancer patients. The patients were enrolled at The Gujarat Cancer and Research Institute, Ahmedabad and were followed for a period of three years. As 85% patients had node-positive disease (N=129), the results were analyzed only for this group of patients. Of the 129 node-positive breast cancer patients, 61% had hyperprolactinemia (PRL >20.0 ng/ml plasma), and ER+ tumors. 67% of the tumors were PR+. Significant correlation was not observed between age, menopausal status and clinicopathological features and ER and PR content. When the patients were subgrouped according to the cut-off levels for the three prognostic indicators i.e. PRL, ER and PR, the difference between the two subgroups of PRL was statistically significant for overall survival (P<0.02). ER+ and PR+ patients had better overall survival than their counterparts. However, the differences were statistically non-significant for both the subgroups. Moreover, ER- hyperprolactinemic patients had unfavourable prognosis (P<0.02) compared to their counterparts. This study suggest that hyperprolactinemia is an important indicator of unfavourable prognosis in node-positive breast cancer patients, both when evaluated singly and in conjunction with steroid receptors, ER-hyperprolactinemic patients had poor prognosis.