In a nutshell
This study examined whether the lymph node ratio could predict outcome in breast cancer patients treated with neoadjuvant chemotherapy. This study concluded that the lymph node ratio could predict prognosis.
Some background
Lymph node involvement (cancer that has spread to the lymph nodes) affects prognosis (outcome) in breast cancer. Lymph nodes are often removed in order to test for the presence of cancer cells. The axillary lymph nodes (those under the arm) are often the lymph nodes tested.
The lymph node ratio (LNR) is calculated as the number of positive lymph nodes divided by the number of lymph nodes removed. This has been shown to be a way to predict prognosis. It is not clear, however, whether the LNR is predictive of outcome following neoadjuvant chemotherapy (treatment delivered before surgery to reduce the size of the tumor).
Methods & findings
The study included 428 patients who underwent surgery after NAC. Of these, 263 did not have cancer in the lymph nodes. 165 did have cancer in the lymph nodes. The LNRs were calculated for patients who had remaining cancer in underarm lymph nodes, after having at least six of those lymph nodes removed. The average number of lymph nodes removed was 14.
Five year disease-free survival was 69.1% for a low LNR, 71.4% for a medium LNR, and 49.3% for a high LNR. LNR was associated with outcome in patients with hormone receptor postive breast cancer (dependent on hormones such as estrogren for growth) and triple negative breast cancer (not dependent on hormones or HER2 for growth).
The bottom line
The study concluded that in patients treated with NAC, the lymph node ratio was predictive of outcomes in both HR positive and TN breast cancers.
Published By :
Annals of Surgical Oncology
Date :
Jul 12, 2016
