Prognostic significance of CD8+ T lymphocytes in breast cancer depends upon both oestrogen receptor status and histological grade

Histopathology. 2011 Jun;58(7):1107-16. doi: 10.1111/j.1365-2559.2011.03846.x. Epub 2011 Jun 24.


Aims: Results of previous studies on the influence of tumour infiltrating lymphocytes on prognosis of women with breast cancer have been mixed. This study re-evaluates the role of tumour-infiltrating lymphocytes as a prognostic marker in women with breast cancer.

Methods and results: Immunochemistry staining of CD8(+) T cells was performed on a tissue microarray of 1953 breast carcinomas. When all tumours were considered, no association between the lymphocyte count and patient survival was found. In univariate analysis, there was a reduced disease-specific survival for women with oestrogen receptor (ER)-positive tumours with high intraepithelial lymphocyte count (P=0.004). In those with ER-negative tumours, the disease-specific survival was improved when the intraepithelial, stromal and total lymphocyte counts were high, the total lymphocyte count also being an independent prognostic marker on multivariate analysis (P=0.031). When stratified by histological grade, on univariate analysis, the previously observed inferior outcome in women with high lymphocyte count and ER-positive tumours remained significant only if tumours were also of low grade, and the superior outcome in those with ER-negative tumours remained significant if tumours were also of high grade.

Conclusions: Our results raise the possibility of different immune-tumour interactions based on ER status and histological grade.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers, Tumor / metabolism
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / genetics
  • Breast Neoplasms / immunology
  • Breast Neoplasms / mortality
  • CD8-Positive T-Lymphocytes / metabolism
  • CD8-Positive T-Lymphocytes / pathology*
  • DNA, Neoplasm / genetics
  • Female
  • Humans
  • In Situ Hybridization, Fluorescence
  • Kaplan-Meier Estimate
  • Lymphocyte Count
  • Lymphocytes, Tumor-Infiltrating / metabolism
  • Lymphocytes, Tumor-Infiltrating / pathology*
  • Prognosis
  • Receptors, Estrogen / metabolism*
  • Survival Rate
  • Switzerland / epidemiology
  • Tissue Array Analysis


  • Biomarkers, Tumor
  • DNA, Neoplasm
  • Receptors, Estrogen