ArticleNPJ breast cancer2026
AI-assisted image analysis of tumor-infiltrating lymphocytes as a prognostic marker in chemotherapy-naïve luminal breast cancer.
Article in NPJ breast cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
In triple-negative and HER2-positive breast cancer, tumor-infiltrating lymphocytes (TILs) are established predictive and prognostic biomarkers, but their role in luminal subtypes remains unclear. We investigated the prognostic significance of TILs using AI-based image analysis in 2298 luminal breast cancers from the DBCG99c cohort, classified by PAM50. Stromal (sTIL) and intraepithelial (iTIL) densities were quantified automatically using a commercial platform. Higher stromal TIL infiltration was associated with improved overall survival, particularly within the first 5 years (heterogeneity p = 0.01). In multivariable models, higher sTILs independently predicted lower risk of distant or any recurrence (sHR = 0.95, 95% CI 0.91-0.99) and improved survival (HR = 0.91, 95% CI 0.85-0.97 early; HR = 0.99, 95% CI 0.97-1.00 late). Intraepithelial TILs were not prognostic. No significant interactions were observed by molecular subtype, nodal status, or grade, although a nonsignificant trend toward stronger iTIL effects appeared in luminal B tumors. AI-based TIL quantification thus provides independent prognostic information in high-risk luminal breast cancer.
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