THE NUMBER OF METASTATIC NODES AS A PROGNOSTIC FACTOR IN ADVANCED BREAST CANCER

Abstract

To determine the adjustment to high dose adjuvant chemotherapy with autologous hematopoietic stem cell transplantation for advanced breast cancer, we examined the prognosis of breast cancer patients based on the number of metastatic nodes. The examination was made on 182 patients with breast cancer operated on in the hospital from 1973 to 1992 who had four or more metastatic axillary nodes with or without metastatic internal mammary nodes, excluding stage IV cancer patients. These patients were classified into two groups according to the number of metastatic nodes. A cut off number of metastatic nodes was set up, and used to divide the patients into two groups. The first group had the same or more number of metastatic nodes than the set up value, and the second group had less. The 10-year disease free survival rate of the two groups were statistically analysed and an univaliant analysis was used between the groups classified by each number of metastatic nodes. The most significant P-value was found between the groups classified by 11 metastatic nodes. The 10-year disease free survival rate of 11 or more metastatic nodes group (28.8%) was significantly poorer than that of the group under 11 (56.2%) (p<0.0001). The same analysis was made on 126 patients with metastatic nodes limited in the axillary region. The results were almost the same. The 10-year disease free survival rate of schirrous carcinoma patients with 7 to 10 metastatic nodes (32.3%) was as poor as that of the 11 or more metastatic nodes group. It suggests that high dose adjuvant chemotherapy is needed to gain better prognosis not only for the patients who have 11 or more metastatic nodes but also for schirrous carcinoma patients with 7 to 10 metastatic nodes, both patient's groups with a high recurrence rate of about 70%.