Abstract. Background. The status of the axillary lymph nodes in nonmetastatic lymph node-positive breast cancer (BC) patients remains the single most important.
Indian J Surg Oncol 1(1):68–75
Original Article
Ratio between positive lymph nodes and total excised axillary lymph nodes as an independent prognostic factor for overall survival in patients with nonmetastatic lymph node-positive breast cancer* Hassan A. Hatoum ⋅ Faek R. Jamali ⋅ Nagi S. El-Saghir ⋅ Khaled M. Musallam ⋅ Muhieddine Seoud ⋅ Hani Dimassi ⋅ Jaber Abbas ⋅ Mohamad Khalife ⋅ Fouad I. Boulos ⋅ Ayman N. Tawil ⋅ Fadi B. Geara ⋅ Ziad Salem ⋅ Achraf A. Shamseddine ⋅ Karine Al-Feghali ⋅ Ali I. Shamseddine
© Indian Association of Surgical Oncology 2010 Hassan A. Hatoum1 ⋅ Faek R. Jamali2 ⋅ Nagi S. El-Saghir1 Khaled M. Musallam1 ⋅ Muhieddine Seoud3 ⋅ Hani Dimassi4 ⋅ Jaber Abbas2 ⋅ Mohamad Khalife2 ⋅ Fouad I. Boulos5 ⋅ Ayman N. Tawil5 ⋅ Fadi B. Geara6 ⋅ Ziad Salem1 ⋅ Achraf A. Shamseddine1 ⋅ Karine Al-Feghali1 ⋅ Ali I. Shamseddine1 ()
1 Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut Medical Center, Beirut, Lebanon 2 Department of Surgery, Division of General Surgery, American University of Beirut Medical Center, Beirut, Lebanon 3 Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon 4 School of Pharmacy, Lebanese American University, Byblos, Lebanon 5 Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon 6 Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon
Abstract Background. The status of the axillary lymph nodes in nonmetastatic lymph node-positive breast cancer (BC) patients remains the single most important determinant of overall survival (OS). Although the absolute number of nodes involved with cancer is important for prognosis, the role of the total number of excised nodes has received less emphasis. Thus, several studies have focused on the utility of the axillary lymph node ratio (ALNR) as an independent prognostic indicator of OS. However, most studies suffered from shortcomings, such as including patients who received neoadjuvant therapy or failing to consider the use of adjuvant therapy and tumor receptor status in their analysis. Methods. We conducted a single-center retrospective review of 669 patients with nonmetastatic lymph nodepositive BC. Data collected included patient demographics; breast cancer risk factors; tumor size, histopathological, receptor, and lymph node status; and treatment modalities used. Patients were subdivided into four groups according to ALNR value (10
79 (11.8) 71 ± 9 590 (88.2) 77 ± 3
39 ± 17 66 ± 5
0.037
ALNR
