Abstract
PURPOSE: To evaluate factors influencing the long-term outcome of patients presenting with 10 or more metastatic axillary lymph nodes (pN3a) after surgery for primary breast cancer. METHOD: Between January 1990 and December 2015, a total of 130 patients with pN3a breast cancer at surgery were identified in our Institutions and included in the study. Twenty-nine of them (22.3%) received neoadjuvant chemotherapy. The Multivariate Cox proportional hazards model was used to determine independent prognostic factors associated with DFS and OS. RESULTS: After a median follow-up of 6.4 years (range 0.87-25 years), 2 patients had a local relapse, 59 distant metastases (1 with local relapse) and 52 patients died. The 5-year DFS and OS rates were 61.8% and 71.5%, respectively. At multivariate analysis, pN3a stage after neoadjuvant chemotherapy (ypN3a) was significantly associated with increased risk of recurrence (HR 1.92, p = 0.02) and death (HR 2.05, p = 0.029). Absence of progesterone receptor (PR) expression was the most important tumor characteristic associated with poor prognosis, both in terms of recurrence (HR 2.55, p /=20%) were significantly associated with a shorter OS (HR 2.03, p = 0.027), but not with DFS. CONCLUSIONS: The results of this study indicate that ypN3a stage, lack of expression of PR, and Ki-67 >/= 20% negatively affect long-term outcome of patients with pN3a breast cancer.
Original language | English |
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Pages (from-to) | 79-86 |
Number of pages | 8 |
Journal | Breast |
Volume | 32 |
DOIs | |
Publication status | Published - Apr 1 2017 |
Keywords
- Adult
- Aged
- Aged, 80 and over
- Axilla
- Breast Neoplasms/chemistry/mortality/pathology/surgery
- Disease-Free Survival
- Female
- Follow-Up Studies
- Humans
- Italy
- Ki-67 Antigen/analysis
- Lymph Nodes/pathology
- Lymphatic Metastasis
- Middle Aged
- Multivariate Analysis
- Neoplasm Staging
- Proportional Hazards Models
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Retrospective Studies
- Survival Rate
- Time Factors
- Breast cancer
- Ki-67
- Progesterone Receptor
- Prognosis
- Stage pN3a