The prognostic value of lymph node status among breast cancer subtypes

• Published in: The American journal of surgery Vol. 209; no. 4; pp. 717 - 724
• Main Authors: Liao, Guo-Shiou, M.D, Chou, Yu-Ching, Ph.D, Hsu, Huan-Ming, M.D., Ph.D, Dai, Ming-Shen, M.D., Ph.D, Yu, Jyh-Cherng, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2015; Elsevier Limited
• Subjects: Age; Breast cancer; Breast cancer subtypes; Breast Neoplasms - classification; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Cancer therapies; Chemotherapy; Confidence intervals; Disease-Free Survival; Endocrine therapy; Epidermal growth factor; Gene amplification; Gene expression; Humans; Lymph node status; Lymphatic Metastasis; Lymphatic system; Mastectomy; Medical prognosis; Metastasis; Middle Aged; Mortality; Multivariate analysis; Overall survival; Patients; Prognosis; Radiation therapy; Recurrence-free survival; Retrospective Studies; Surgery; Survival Rate; Time Factors; Tumors; Recurrence-free survival; Overall survival; Breast cancer subtypes; Lymph node status
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2014.05.029

Abstract Background Breast cancer subtypes (BCSs) are predictive of responses to specific therapies and of prognostic value for clinical outcomes. This study aimed to evaluate the relative 5-year overall survival (OS) and recurrence-free survival rates (RFS) based on lymph node (LN) status among BCSs. Methods Medical records of 1,399 breast cancer patients treated from 2006 to 2011 were retrospectively reviewed. Pathologic findings, type of treatment, and OS and RFS were evaluated for 5 molecular subtypes. Results Luminal A cancers accounted for 40.9% of the total, luminal B 21.5%, luminal human epidermal growth factor receptor 2 (HER2) 24.8%, HER2 6.9%, and triple negative 5.9%, of which 30% ( n = 395) were LN positive. Analysis of patient characteristics showed significant differences among BCSs in age, tumor size, LN status, chemotherapy, and endocrine therapy. Adjustments for age and tumor size revealed significant differences in OS according to the nodal status in luminal A, luminal B, and luminal HER2 subtypes, and with RFS in the luminal B and luminal HER2 subtypes. Conclusion LN status in BCS presents an important prognostic factor of OS and RFS.