AgNORs and their relationship to cell size, histological grade, lymph node involvement, metastases, and survival pattern in carcinoma of the breast: a study from south India.

An AgNOR count using the Smith and Crocker [Histopathology 12:113-125, 1988] method of staining was performed on 200 cases of carcinoma of the breast. A count of coarse AgNORs per nucleus was made on 50 random cells and the mean of their number per nucleus calculated. The relationship of a single variable "AgNOR count" to other variables such as cell size, histological grade, number of positive ipsilateral axillary lymph nodes, and presence of metastasis in regions other than the ipsilateral axillary lymph nodes was found using a univariate method of analysis. Also, the effect of different independent variables, e.g., number of AgNORs, cell size, histological grade, number of positive axillary lymph nodes, and metastasis on a single variable, i.e., 4-year period of survival, was also assessed by a univariate method of statistical analysis. It was found that the AgNOR count was significantly related to the cell size, histological grade, and presence of metastasis. Large cells, grade III tumors, and neoplasms with evidence of metastasis showed larger numbers of AgNORs in their nuclei. It was observed that the number of AgNORs significantly affected the 4-year survival of patients. The higher the AgNOR counts, the poorer were the chances of surviving for 4 years. The other factors that influenced survival in the present study were the number of positive axillary lymph nodes and metastasis to sites other than axillary lymph nodes.