Role of Metastatic Lymph Nodes to Totally Removed Lymph Nodes Ratio in Breast Cancer?

Abstract

Abstract Aim To determine prognostic ratio of metastatic lymph nodes to totally removed lymph nodes (MLN/TRLN) on overall and progression-free survival with diagnosis of breast cancer. Material and method Radiation Oncology department of Kayseri Training and Research Hospital, relationship of MLN/TRLN between prognosis and other prognostic factors was evaluated in T1-3 and N1-3 non-metastatic breast cancer patients. Results Two hundred female patients and 5 male patients with an average age of 56 years were enrolled in this study. Of all patients, 63.4% of the patients were postmenopausal and modified radical mastectomy was performed in 96.6% of them. While 93.2% of the patients were diagnosed with invasive ductal carcinoma, 52.7% of them had clinical N1 disease, 62% of them were staged as T2, 94% of them received chemotherapy and 57.1% of them received hormonal therapy. Metastatic lymph node ratio below 0.2 was 48.8%, between 0.21–0.65 it was 35.1% and above 0.65% it was 16.1%. Five-year Overall survival and progression-free survival rates were 76% and 58% respectively. Statistically significant difference was found between MLN/TRLN and age (p = 0.044), chemotherapy (p = 0.039), pathological lymph nodes (p <0.001) according to Pearson's Chi-Squared test. Factor affecting overall survival was Progesterone receptor status (p = 0.021) and for progression-free survival they were gender (p = 0.003) and human epidermal growth factor receptor 2 (p = 0.018). Univariate and multivariate analysis found that gender (p = 0.04, OR 5.9, CI: 1.7–19.6) and lymph node (p = 0.05, OR: 1.4, CI: 0.9–2.1) were significant factors affecting progression-free survival. Conclusion MLN/TRLN was shown to have no effect on prognosis in non-metastatic breast cancer patients due to small number of patients and short follow-up period.