Patients in stage IV are rarely free of disease however 10 to 20 of these patients nrttfy survive with minimal disease for S to 10 years

• Patient age. Patients diagnosed at age younger than 35 years have a worse prognos-

• Tumor size. In general, patients with a larger tumor have a worse prognosis.

• Nuclear grade describes the size and shape of the nucleus in tumor cells and the percentage of tumor cells that are dividing. A high nuclear grade signifies that a tumor is growing quickly and indicates a worse prognosis.

• Lymph node involvement. Patients with node-positive disease have a worse pro-

• Hormone-receptor status. Patients with negative-ER and negative-progesterone-receptor (PR) tumors have a worse prognosis.

• HER-2/neu protein expression. Patients with HER-2/neu overexpression have a worse prognosis.

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