Signs of Cancer in the Lymph Nodes as a Marker for Outcomes in Women Under 40.

This study analysed how well signs of cancer in the lymph nodes (immune glands) is at predicting outcomes for women who had breast cancer treatment. 

The authors found that women who had no signs of tumor in either the breast or lymph nodes had the best outcomes.

After treatment of breast cancer, a complete pathologic response indicates that there are no signs of tumor left in the patient. This is the best outcome possible and results in the longest overall survival. Another marker is pathologic nodal response, where no signs of tumor remain in the lymph nodes. It is not known how well this marker is in predicting outcomes for patients.

This study consisted of 155 women aged under 40 who had breast cancer treated with neoadjuvant chemotherapy and surgery. The patients may or may not have undergone radiation therapy. Patients were classified into groups based on signs of cancer that remained after treatment. A pathologic complete response was defined as no evidence of tumor in the breast or lymph nodes. Partial response was considered if there was no evidence of tumor in the breast, but there was in the lymph nodes, or vice-versa. Overall survival was used as the measure of success.

 Of all the patients, 25.2% achieved a pathologic complete response and 36.8% achieved a partial response. Overall survival was worse for patients who had a partial response compared to a complete response. No difference was seen in overall survival between patients who had signs of tumor in the breast alone compared to those who had signs of tumor in the breast and lymph nodes.

The study concluded that pathologic nodal response is not a good marker for overall survival in breast cancer in women under 40.

This study was very small with only 155 patients. Breast cancer in women under 40 is often complicated by genetic factors which may have affected the results of this study.