Prognostic value of metastatic axillary lymph node ratio in node-positive breast cancer treated by breast conserving surgery.

Ying ZHENG; Qin CHEN; Zhijie LIANG; Miaomiao JIA; Xuchen CAO

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Prognostic value of metastatic axillary lymph node ratio in node-positive breast cancer treated by breast conserving surgery.

Author: Ying ZHENG ¹ ; Qin CHEN ¹ ; Zhijie LIANG ¹ ; Miaomiao JIA ¹ ; Xuchen CAO ²
Author Information

1. The First Department of Breast Cancer Surgery, Key Laboratory of Breast Cancer Prevention and Therapy of the Ministry of Education, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.
2. The First Department of Breast Cancer Surgery, Key Laboratory of Breast Cancer Prevention and Therapy of the Ministry of Education, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China. Email:cxc@medmail.com.cn.
Publication Type:Journal Article
MeSH: Axilla; Breast Neoplasms; diagnosis; surgery; Disease-Free Survival; Female; Humans; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Mastectomy, Segmental; Multivariate Analysis; Neoplasm Staging; Prognosis; Retrospective Studies
From: Chinese Journal of Oncology 2015;37(1):41-46
CountryChina
Language:Chinese
Abstract:
OBJECTIVETo evaluate the prognostic value of lymph node ratio (LNR) as compared with the number of pN staging in patients with axillary lymph node-positive breast cancer treated by breast conserving surgery.
METHODSWe performed a retrospective analysis of the clinical data of patients who received breast conserving surgery and with positive lymph nodes (n = 152) between 1998 and 2007. The disease-free survival (DFS) and overall survival (OS) were compared based on the LNR and pN staging.
RESULTSA total of 152 patients were classified as pN1 in 114, pN2 in 23, and pN3 in 15 cases. Among the 152 cases, 114 cases had a LNR ≤ 0.20, 26 cases had 0.21-0.65, and 12 cases had a LNR>0.65. Univariate analysis showed that number of dissected lymph nodes, LNR, pN stage, ER/PR status and radiotherapy were significant prognostic factors for DFS and OS (P < 0.05 for all). Age and chemotherapy were prognostic factors only for OS (P < 0.05). Multivariate analysis indicated that LNR was an independent prognostic factor for DFS and OS (P < 0.05 for both). pN stage had no significant effect on DFS or OS (P > 0.05 for both). In the pN subgroup analysis, LNR was also showed to be significantly correlated with the prognosis of patients.
CONCLUSIONSLNR is superior to pN staging as a prognostic factor in axillary lymph node-positive breast cancer patients treated by breast conservation surgery, and can be used as one of independent prognostic predictors for the patients.