Immunology: breast cancer

Circulating anti-tumor and autoantibodies in breast carcinoma: relationship to stage and prognosis

Serum antibodies to breast tumor antigen(s) and circulating autoantibodies were tested in 175 patients with various stages of carcinoma of the breast, followed for a mean period of 51 months. Antibodies to surface membrane and to cytoplasmic antigens of autologous and allogeneic tumor cells were measured. Peripheral lymphocyte count and skin reaction to six recall antigens were also tested. Patients with metastatic disease had significantly lower prevalence of antibodies to autologous tumor cells and lower total lymphocyte count than patients with early breast cancer. Patients with locally advanced disease (greater than or equal to 4 positive axillary nodes) had the highest frequency of anti-tumor antibodies, the second highest lymphocyte count, but with the lowest prevalance of autoantibodies. Presence or absence of anti-tumor or autoantibody did not correlate with results of skin tests or other standard blood tests. Among patients with locally advanced or metastatic breast cancer, those who had a positive skin test or whose lymphocyte count was 1500 to 2500 per cu mm had significantly better 5-year absolute survival rates (p = 0.04, p = 0.002, respectively). This study suggests that in patients with locally advanced or metastatic breast cancers, skin test reactivity and optimal peripheral lymphocyte count may be useful prognostic indicators. In contrast, neither the presence of anti-tumor antibodies to membrane or cytoplasmic antigens, nor the presence of autoantibodies, correlates with prognosis in patients with early or late breast cancers.