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Prognostically Distinctive Subgroup in Pathologic N3 Breast Cancer
Yun Yeong Kim1, Heung Kyu Park1, Kyung Hee Lee1
1Department of Surgery, Breast Cancer Center, Gachon University Gill Medical Center, Incheon, Korea.
Journal of Breast Cancer
|July 7, 2016
Summary
Prognostic subgroups exist within advanced N3 breast cancer. Tumor biological subtype, particularly hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status, significantly impacts recurrence risk and survival outcomes.
Area of Science:
- Oncology
- Breast Cancer Research
- Clinical Pathology
Background:
- Pathologic N3 (pN3) breast cancer is characterized by extensive lymph node metastasis.
- Prognostic stratification within pN3 disease is crucial for personalized treatment strategies.
Purpose of the Study:
- To identify prognostically distinct subgroups among patients diagnosed with pN3 breast cancer.
- To determine the key factors influencing disease recurrence and survival in this patient population.
Main Methods:
- Retrospective review of 220 pN3 breast cancer patients treated between 2006 and 2012.
- Analysis of disease-free survival (DFS) and overall survival (OS) following adjuvant therapy.
- Logistic regression to identify predictors of tumor recurrence, including age, neutrophil/lymphocyte ratio, nodal ratio, and molecular phenotype.
Main Results:
- Five-year DFS and OS rates were 67.8% and 86.1%, respectively.
- Younger age (<35 years), high neutrophil/lymphocyte ratio (>3.0), high nodal ratio (>0.65), and specific molecular subtypes were associated with increased recurrence risk.
- Tumor biological subtype was the most significant predictor of recurrence, with 5-year DFS rates ranging from 82% (HR+HER2-) to 37% (triple-negative).
Conclusions:
- Clinical outcomes for pN3 breast cancer patients are heterogeneous.
- Tumor biological subtype is the primary prognostic factor in pN3 disease.
- Patients with HR+HER2- pN3 breast cancer demonstrated a prognosis comparable to stage II breast cancer patients.
