The prognostic significance of tumour-stroma ratio in oestrogen receptor-positive breast cancer

C. L. Downey, S. A. Simpkins, J. White, D. L. Holliday, J. L. Jones, L. B. Jordan, J. Kulka, S. Pollock, S. S. Rajan, H. H. Thygesen, A. M. Hanby, V Speirs

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BACKGROUND: A high percentage of stroma predicts poor survival in triple-negative breast cancers but is diminished in studies of unselected cases. We determined the prognostic significance of tumour-stroma ratio (TSR) in oestrogen receptor (ER)-positive male and female breast carcinomas.

METHODS: TSR was measured in haematoxylin and eosin-stained tissue sections (118 female and 62 male). Relationship of TSR (cutoff 49%) to overall survival (OS) and relapse-free survival (RFS) was analysed.

RESULTS: Tumours with ≥49% stroma were associated with better survival in female (OS P=0.008, HR=0.2-0.7; RFS P=0.006, HR=0.1-0.6) and male breast cancer (OS P=0.005, HR=0.05-0.6; RFS P=0.01, HR=0.87-5.6), confirmed in multivariate analysis.

CONCLUSIONS: High stromal content was related to better survival in ER-positive breast cancers across both genders, contrasting data in triple-negative breast cancer and highlighting the importance of considering ER status when interpreting the prognostic value of TSR.

Original languageEnglish
Pages (from-to)1744-1747
Number of pages4
JournalBritish Journal of Cancer
Issue number7
Early online date18 Feb 2014
Publication statusPublished - 1 Apr 2014

Bibliographical note

We are grateful to Breast Cancer Campaign for funding our collection of male breast carcinomas and for supporting DLH and SP. SAS was funded by the Wolfson Foundation and a Wellcome Trust Vacation Scholarship. HHT was funded by Cancer Research UK. We convey special thanks to members of the Leeds Breast Team for input and support at various stages of this project.


  • breast cancer
  • male
  • stroma
  • tumour-stroma ratio
  • prognosis


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