Differential Prognostic Value of Residual Nodal Burden in Breast Cancer Subtypes
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View abstract on PubMed
Summary
This summary is machine-generated.Residual nodal burden significantly impacts breast cancer survival differently across subtypes. Triple-negative breast cancer shows the greatest survival difference based on nodal status after chemotherapy.
Area Of Science
- Oncology
- Breast Cancer Research
- Clinical Prognostics
Background
- Residual cancer burden (RCB) index is prognostic post-neoadjuvant chemotherapy (NAC) for breast cancer (BC).
- Current RCB index lacks subtype specificity and precise evaluation of residual nodal burden (RNB).
Purpose Of The Study
- To precisely define the impact of residual nodal burden (RNB) on survival across different breast cancer (BC) subtypes.
- To analyze how RNB affects mortality risk stratified by BC molecular subtypes.
Main Methods
- Analysis of adult women with non-metastatic breast cancer (BC) from the National Cancer Database (NCDB) (2006-2021).
- Inclusion criteria: NAC followed by surgery within 8 months.
- Evaluation of RNB as a mortality predictor using multivariable logistic regression and Kaplan-Meier survival analyses.
Main Results
- ypN stage was the strongest mortality predictor; ypN3 vs ypN0 showed an OR of 8.85.
- RNB's survival impact was most pronounced in triple-negative breast cancer (TNBC), with a 64% 5-year OS difference (ypN0 vs ypN3).
- The ER+/HER2- subtype showed the least survival difference (25% 5-year OS) between ypN0 and ypN3.
Conclusions
- Residual nodal burden (RNB) significantly influences breast cancer (BC) survival in a subtype-dependent manner.
- ypN status is a more critical mortality predictor in TNBC compared to other BC subtypes.
- Future therapeutic strategies for residual nodal disease should consider BC subtype-specific prognostic differences.
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