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

To determine prognostic ratio of metastatic lymph nodes to totally removed lymph nodes (MLN/TRLN) on overall and progressionfree survival with diagnosis of breast cancer. 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. 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 progressionfree 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 progressionfree survival.

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.