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The prognostic value of lymph node ratio in survival of non-metastatic breast carcinoma patients

  • Epidemiology
  • Published:
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Abstract

Purpose

This study was conducted to assess the correlation between lymph node ratio (LNR) and prognosis of non-metastatic invasive breast carcinoma.

Method

This retrospective study examined 455 patients who were diagnosed with non-metastatic, unilateral invasive breast carcinoma and underwent either breast conservative surgery (BCS) or modified radical mastectomy (MRM) with axillary lymph node dissection (ALND) with at least one lymph node identified in the ALND specimen. Receiver operating characteristics (ROC) curve analysis was used to find out predictive cut-off values of the LNR and negative lymph nodes (NLN).

Results

The median follow-up duration was 38 months. The median DFS and OS were 68 months and 72 months, respectively. 25.1% of patients had reported recurrence. The optimal cut-off value of LNR was 0.40. LNR was found to correlate significantly with pathological T (p < 0.001), pathological N (p < 0.001), and NLN (p < 0.001). Univariate analysis of the patients showed that the age group ≤ 35 years, menstrual status, pathological T, nodal status, lymphovascular invasion (LVI), perineural invasion (PNI), tumor grade, estrogen receptor (ER), progesterone receptor (PR), molecular subtypes, LNR, and NLN can affect disease-free survival (DFS) (p < 0.05) and OS (p < 0.05). Multivariate analysis showed that the pathological T (p < 0.001), menstrual status (p = 0.030), and LNR (p < 0.001) were the independent prognostic factors for DFS. Pathological T (p < 0.001) and LNR (p < 0.001) were the independent prognostic factors affecting OS.

Conclusion

LNR is the independent prognostic factor of DFS and OS for non-metastatic breast carcinoma.

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Authors and Affiliations

  1. Department of Radiotherapy, Institute of Post Graduate Medical Education and Research, Kolkata, India

    Dharmendra Singh & Avik Mandal

  2. Department of Radiation Oncology, All India Institute of Medical Sciences, Patna, 801507, India

    Dharmendra Singh

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  1. Dharmendra Singh
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Contributions

Concept and design: DS; data collection: DS and AM; data analysis: DS; manuscript: DS and AM; final approval: DS and AM.

Corresponding author

Correspondence to Dharmendra Singh.

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The authors declare that they have no conflicts of interest.

Ethical approval

The local Ethics Committee of Institute of Post Graduate Medical Education and Research, Kolkata waived ethical approval in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

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Singh, D., Mandal, A. The prognostic value of lymph node ratio in survival of non-metastatic breast carcinoma patients. Breast Cancer Res Treat 184, 839–848 (2020). https://doi.org/10.1007/s10549-020-05885-y

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