الفهرس 
Failure of the immune responseOnly 14 pages are availabe for public view
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Abstract
Prognostic information are needed to individualize the
decision making of the multidisciplinary management of breast cancer patients.
The cun·ently used prognostic markers failed to discriminate up to 30% of the patients. They are
mainly related to tumour biology and ignore the patients factors represented by her immunological
capacity to fight against the disease.
It has been clearly established that the immune responses play an important role in the fight
against malignant diseases with an impact on prognosis.
The immune responses against malignant diseases are found to be specific responses via the
activation of cytotoxic T lymphocytes and lymphokines, and non specific via the activation of
natural killer cells and macrophages.
Evaluation of the antitumour immune responses might be taken as a prognosticator for the outcome
of the disease.
This evaluation IS done by evaluation of local antitumour responses, the evaluation. of
haematological parameters of T cell functions, or by the assessment of immunological response in
the regional lymph nodes.
The aun of this work is to describe the possible prognos1s after surgery for operable cancer by
analysis of nodal cellular immunological response.Between I\ ay 1998 and May 2000, 34 female patients
diagnosed as I aving breast carcinoma were admitted, investigated and operated upon at surgery
department, El Dcmerdash llos1 itaL II patients (32.4%) underwent modified radicalmastccton y,
while 23 patients (67.6%) underwent wide local excision and axillary clearance.
Immunomc 1Jhological patterns of the lymph nodes were assessed usi1 g routine hematoxylin-eosin
stained slides.
Of the ex; mined group, 13 patients (38.2%) have good response, I 8 pati :nts (52.9%) have poor
response, and three patients (8.8%) 1ave an average response. Four patients ( 11.8%)
show c< mbincd paracortical hyperplasia and sinus
histiocytosis.
We conclu< ed that, these demonstrations might be taken as a sign of a p tssible prognosis, with an
impact on further management of .he patients, i.e., in patients with good responses, with a1
expected good prognosis, the support of the immune system md its responses might be considered by
prevention of cl emotherapy with its immunosuppressive effects, and the us• of new modality
treatment options i.e. gene therapy lor augmc 1tation of the immune responses.
Axillary 11< de biopsy as a guide for immunological status of a given patient might be advised
before the plan of treatment. Thos< recommendations should await further validation support• d by
long term clinical trials.