Abstract
Ten to 30% of early breast cancer (EBC) patients develop brain metastasis (BM) during their follow-up. In this study, we aimed to evaluate importance of the lymph node ratio (LNR) in development of BM in EBC cases. Ninety patients whom had axillary metastases in lymph nodes at their initial diagnosis and developed BM during 5-year follow-up were detected in 950 EBC patients. LNR values were calculated for all patients and after categorization into 4 molecular sub-types as luminal A, luminal B HER-2 (+), HER-2 overexpressing and basal- like. Comparison was with control group patients who had similar characteristics. In the comparison of all molecular sub-types of LNR, 54.9% and 28.4% values were found in patients with and without BM respectively (p<0.001). In the comparison of the LNR with control groups, a statistically significant differences were found with luminal A with BM (p=0.001), luminal B HER-2 (p=0.001), HER-2 overexpressing (p=0.027) and basal-like groups (p<0.001). In the evaluation of patients with BM, the highest ratio was found in the basal-like group (67.9%) and there was a statistically significant difference between this group and the others (p=0.048). EBC patients developing BM within 5 years follow- up had significantly higher LNRs for all molecular sub-types, especially in the basal-like group. Larger scale studies are now needed for evaluating LNR prognostic importance for EBC regarding BM development.
Highlights
Ten to 30% of early breast cancer patients (EBC) develop central nervous system metastasis during their follow-up (Barnholtz-Sloan et al, 2004; Lin et al, 2004)
We aimed to evaluate importance of the lymph node ratio (LNR) in development of brain metastasis (BM) in EBC cases
Materials and Methods: Ninety patients whom had axillary metastases in lymph nodes at their initial diagnosis and developed BM during 5-year follow-up were detected in 950 EBC patients
Summary
Ten to 30% of early breast cancer patients (EBC) develop central nervous system metastasis during their follow-up (Barnholtz-Sloan et al, 2004; Lin et al, 2004). Brain metastasis (BM) is one of the most important factor for survival of the patients with breast cancer. There have been significant studies related with the axillary lymphatic evaluation of EBC in recent years (Woodward et al, 2006; Hatoum et al, 2009; VinhHung et al, 2009; Goldhirsch et al, 2011). Molecular classification of breast cancer is widely used in the clinic (Goldhirsch et al, 2011) In this purpose, the LNR differences based on molecular subtype of the EBC patients who had developed BM in 5 years during their follow-up compared to control group in the current study
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