[Relation of tumor size, lymph node status and prognosis in breast cancer]

Tumor size and the extent of axillary lymph node involvement are the two most important prognostic factors for breast cancer, but their relation is not clear. Data on 2189 cases of radical surgery from 1956-1985 showed a linear relation between tumor size and percentage of cases with positive lymph node involvement. A negative relation was noted between tumor size, the extent of lymph node involvement and prognosis. There was a significance difference in survival rate between one group, two group or more lymph nodes involve. The worst prognosis was seen in those patients with level 3 lymph nodes involve. Tumor size and lymph node status were found to be independent but additive prognostic indicators. If there was no lymph node involvement, the survival rate was decreased because of tumor size. In cases of 1-3 and 4-6 lymph nodes involved, the survival rate was not different when tumor size was less than 5 cm, but there was a significant difference when tumor size large than 5 cm. In cases of more than 7 nodes involved, the survival rate decreased regardless of tumor size. Lymph node metastasis was more important than tumor size in prognosis. The relation of different TNM combination with prognosis was investigated, and the importance of the treatment of internal mammary lymph node in breast cancer was emphasized.