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Tumoral Carcino Embryonic Antigen (CEA) and Tissue Polypeptide Antigen (TPA) expression was investigated by immunoperoxidase technique on paraffin embedded tissues of 191 patients with infiltrating breast cancer and negative axillary nodes. TPA was almost always detected at high levels. CEA staining was evenly distributed, but high CEA positivity was associated with higher TPA expression. Lower levels of both markers were found in medullar carcinomas as well as in cancers larger than 1 cm. Higher estrogen and progesterone receptor content was associated with higher expression of tissue CEA and TPA. After a median follow-up of 9 years, neither tissue CEA nor tissue TPA show any prognostic value.

Between 1978 and 1986 we treated 318 consecutive patients with stage I breast cancer. Median follow-up time is 8.5 years. In all cases the invasion of peritumoral lymphatic (LVI) and blood vessels (BVI) was studied by the hematoxylin-eosin staining method. Different ten-year survival (86% vs 67%) and disease-free survival (82% vs 61%) probabilities were found in patients with or without LVI. BVI showed low sensitivity and specificity, therefore vessel invasion was reassessed on 190 specimens with the immunoperoxidase technique using the Ulex Europeus Type 1 lectine. A significant correlation between the vessel staining intensity and the presence of intraluminal metastases was found. With this method a better sensitivity was obtained, but it was associated with a loss of specificity and prognostic significance.

Thirty-eight consecutive patients with locally advanced (stage IIIb/IVa-c) or inflammatory breast cancer (stage IVd) underwent neoadjuvant chemotherapy in our department between 1978-1990. All patients in this phase II study, received from three to five courses of neoadjuvant AVM regimen (Adriamycin, Vincristine, Methotrexate). Complete or partial response (CR+PR) was observed in 94.6% of this group of patients after the completion of therapy (chemotherapy + surgery + consolidation therapy) and in 97.3% at the completion of neoadjuvant chemotherapy alone. The overall 5-year median survival was 31.86% with a median disease-free time of 13 months. Only one patient showed progression of disease before surgery and was excluded from the study. The annual incidence of relapse in this study was 35% and the first metastatic event was observed locally in 1/4 of the patients examined. Low to moderate toxicity observed was reversible and easily controlled. We conclude that AVM neoadjuvant chemotherapy is a well tollerated regimen with long term clinical response in locally advanced breast cancer patients.