J Breast Cancer.  2008 Dec;11(4):194-200. 10.4048/jbc.2008.11.4.194.

The Impact of the Ratio of Positive Nodes to Removed Nodes on Recurrence and Overall Survival in Node Positive Breast Cancer Patients

Affiliations
  • 1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. drjh.yang@samsung.com

Abstract

PURPOSE: The status of axillary lymph node (LN) metastasis is the most important prognostic factor in breast cancer. Postoperative regional nodal radiotherapy is recommended usually based on the number of metastatic LNs, which is associated with the total number of removed LNs during the axillary dissection. We evaluated the prognostic impact of the ratio of metastatic LNs to removed LNs on disease free survival and overall survival in breast cancer patients.
METHODS
The medical records of 743 breast cancer patients with metastatic axillary LNs and treated at Samsung Medical Center between 1994 and 2003 were retrospectively analyzed. The ratio of metastatic/removed LNs as well as the other prognostic factors were analyzed.
RESULTS
Both disease-free survival and overall survival rates were significantly worse in patients with a ratio of metastatic/removed LNs greater than 20% compared to those patients with a ratio of less than 20% (p=0.028, p<0.001, respectively). In patients with T1-2 and N1 breast cancer, the ratio of metastatic/removed LNs greater than 20% was significantly associated with poorer disease-free survival (p=0.027).
CONCLUSION
A ratio of metastatic/removed LNs greater than 20% in the axilla can be an adverse prognostic factor in breast cancer patients with axillary node metastasis. In T1-2 N1 breast cancer patients, adjuvant radiotherapy as well as more aggressive chemotherapy therapy may be indicated.

Keyword

Breast cancer; Lymph node; Ratio; Survival

MeSH Terms

Axilla
Breast
Breast Neoplasms
Disease-Free Survival
Humans
Lymph Nodes
Medical Records
Neoplasm Metastasis
Radiotherapy, Adjuvant
Recurrence
Retrospective Studies
Survival Rate
Sydnones
Sydnones

Figure

  • Fig 1 Disease-free survival and overall survival by the ratio of metastatic/removed axillary lymph nodes with the cut-off value of 20% in the breast cancer patients with positive axillary lymph node(s) (n=743).

  • Fig 2 Disease-free survival and overall survival by the ratio of metastatic/removed axillary lymph nodes with the cut-off value of 20% in the patients with T1-2 and N1 breast cancer (n=387).


Cited by  1 articles

The Prognostic Significance of the Lymph Node Ratio in Axillary Lymph Node Positive Breast Cancer
Ji-Yoon Kim, Mi-Ryeong Ryu, Byung-Ock Choi, Woo-Chan Park, Se Jeong Oh, Jong-Man Won, Su-Mi Chung
J Breast Cancer. 2011;14(3):204-212.    doi: 10.4048/jbc.2011.14.3.204.


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