Impact of selected tumor and patient characteristics on outcome of lymph node-positive breast cancer patients.

Abstract

66 Background: Axillary lymph node (ALN) involvement remains the most significant factor affecting long term survival in breast cancer (BC) patients, and the risk of treatment failure is increased with the higher the number of ALN involvement, The aim of this study was to determine the impact of tumor characteristics; tumor size and number of positive lymph nodes and, ER and HER-2, as well as patient characteristics on DFS of patients with Lymph node positive Breast Cancer Patients who received Adjuvant Treatment. Methods: We retrospectively reviewed data of 704 patients with BC and ALN involvement who received adjuvant treatment in the period between 2010 and 2012. DFS outcomes were estimated with the Kaplan-Meier method and compared using the log rank test to determine. The effect of prognostic factors on BC outcomes. Results: Median age was 50 years (SD±12.024, Range 21-88). About 83.7% of the tumors were IDC,. About 30.4%of the tumors were grade III. Median tumor size was 5 cm (SD± 1.3745, Range 1-7).Median number of positive axillary LN was 4 (SD± 4.987, Range 1-37). Regarding receptor expression; 21.2% were HER-2 +ve, 58.7% were ER +ve and about 30.4 were triple negative. Median DFS was 20 months (SD± 14.511, Range 1-60). Cox regression showed that age, positive ER status and more than 3 ALN involvement had a statistically significant impact on DFS ( p<0.001 for all ), however, Tumor size, HER-2 overexpression, patient menstrual status had no significant effect. ER positive age >50 years was associated with prolonged DFS of 23 months (95%CI=20.641-25.359) versus 19 months (95% CI=17.598-20.402) for age≤50 years (p<0.001). ER positive status was associated with prolonged DFS of 22 months (95%CI=20.290-23.710) versus 17 months (95% CI=14.049-19.951) for ER negative (p<0.001).The group of patients with ≤3 positive dissected LN was associated with statistically significant prolonged DFS of 25 months (95%CI=22.286-27.714) versus 15 months (95%CI = 12.353-17.647) for patients with>3 positive dissected LN (p<0.001). Conclusions: These study indicate that the age, ER status and more than 3 ALN involvement have impact on DFS in Lymph node positive Breast Cancer Patients.