Does the number of lymph nodes examined in patients with lymph node-negative breast carcinoma have proanostic significance?

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review

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Author(s)

  • Joseph K. Salama
  • Ruth Heimann
  • Neil Mehta
  • Steven J. Chmura
  • Rachana Singh
  • Johnny Kao

Detail(s)

Original languageEnglish
Pages (from-to)664-671
Journal / PublicationCancer
Volume103
Issue number4
Publication statusPublished - 15 Feb 2005
Externally publishedYes

Abstract

BACKGROUND. There are conflicting data on the prognostic significance of the number of lymph nodes examined in patients with lymph node-negative breast carcinoma. Therefore, the authors analyzed the impact of the number of tumor-free axillary lymph nodes on disease-free survival (DFS) in two distinct patient populations. METHODS. Eight hundred thirty-three consecutive patients with breast carcinoma who underwent mastectomy between 1927 and 1987 and 1094 consecutive patients with breast carcinoma who underwent with breast-conservation therapy between 1984 and 2001 were diagnosed pathologically with negative axillary lymph node status. Patients were stratified into 4 groups according to the number of lymph nodes examined: Group 1 had 1-3 lymph nodes examined, Group 2 had 4-9 lymph nodes examined, Group 3 had 10-20 lymph nodes examined, and Group 4 had > 20 lymph nodes examined. RESULTS. In the mastectomy cohort, with a median follow-up of 153 months, the 10-year DFS rate was 70%, 65%, 79%, and 81% for Groups 1-4, respectively. On multivariate analysis, pathologic tumor size (P <0.001) and the number of lymph nodes examined (P = 0.010) were significant predictors for long-term DFS. In the breast-conservation cohort, with a median follow-up of 53 months, the 5-year DFS rate was 90%, 91%, 92%, and 95% for Groups 1-4, respectively. On multivariate analysis, the only predictors of DFS were method of detection (clinically vs. mammographically) (P = 0.003) and tumor size (P = 0.035). CONCLUSIONS. The recovery of <10 lymph nodes in lymph node-negative patients who underwent mastectomy resulted in a 10-15% decreased long-term DFS rate compared with patients who had a more extensive axillary assessment. However, the number of lymph nodes examined did not have an impact on the DFS rate in a contemporary cohort of patients who underwent breast-conservation therapy, which included radiation. © 2005 American Cancer Society.

Research Area(s)

  • Axillary dissection, Breast carcinoma, Lymph nodes, Prognosis

Citation Format(s)

Does the number of lymph nodes examined in patients with lymph node-negative breast carcinoma have proanostic significance? / Salama, Joseph K.; Heimann, Ruth; Lin, Fen; Mehta, Neil; Chmura, Steven J.; Singh, Rachana; Kao, Johnny.

In: Cancer, Vol. 103, No. 4, 15.02.2005, p. 664-671.

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review