Prognostic Factors in Operated Stage IIIC, Pathological N3a Breast Cancer Patients

The aim of this retrospective study was to evaluate the prognostic factors in patients operated for stage IIIC breast carcinoma who had > 10 positive axillary lymph nodes (pN3a).

The medical records of 302 operated N3a breast cancer patients without distant metastasis followed up in 2 medical oncology clinics in Ankara between January 1998 and June 2013 were evaluated retrospectively.

The median age was 50 (21-83) years. The median follow-up time was 43 (5-191) months. The patients were divided into 4 subgroups according to hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. There were 151 (50.0%) patients in the HR+/HER2- group, 80 (26.5%) patients in the HR+/HER2+ group, 42 (13.9%) patients in the HR-/HER2+ group, and 29 (9.6%) patients in the triple negative (TN) group. At the time of analysis, 155 (51.3%) patients had recurrent disease and 117 (38.7%) patients had died. The median disease-free survival (DFS) and overall survival (OS) times were 46.0 and 78.0 months, respectively. Both the DFS and OS in the HR+/HER2- group were longer than in the other groups (log-rank p = 0.034 and p = 0.016, respectively). Menopausal status, progesterone receptor (PgR) status, and lymph node ratio (LNR; defined as the number of positive lymph nodes compared to the total number of removed lymph nodes) were found to be independent prognostic factors (p = 0.019, p = 0.001, and p = 0.012, respectively).

Menopausal status, PgR status, and LNR were independent prognostic factors in operated N3a breast cancer patients, who are underrepresented in breast cancer trials.