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Superiority of Pathologic Lymph Node Ratio over Positive Lymph Node Count in Operated Early-Stage Breast Cancer
Zuhat Urakçı1, Muhammet Ali Kaplan1, Zeynep Oruç1
1Department of Medical Oncology, Faculty of Medicine, Dicle University, 21280 Diyarbakır, Türkiye.
Annali Italiani Di Chirurgia
|December 26, 2024
Summary
The lymph node ratio (LNR) is a more effective prognostic indicator than the number of positive lymph nodes in early-stage breast cancer. LNR provides crucial prognostic information, especially in specific patient subgroups.
Area of Science:
- Oncology
- Breast Cancer Research
- Clinical Prognostics
Background:
- Axillary lymph node status is critical for breast cancer prognosis.
- The lymph node ratio (LNR) may offer superior prognostic value over the simple count of positive lymph nodes.
Purpose of the Study:
- To compare the prognostic capability of LNR versus pathologic lymph node count in early-stage breast cancer.
- To determine if LNR is a more accurate predictor of disease-free survival (DFS).
Main Methods:
- Retrospective analysis of 3053 non-metastatic, lymph node-positive breast cancer patients (2004-2018).
- Patients stratified into LNR risk groups: low (≤0.20), intermediate (0.21-0.65), and high (>0.65).
- Comparison of DFS and overall survival (OS) based on LNR and pathologic lymph node (pN) staging.
Main Results:
- LNR was an independent prognostic factor for DFS (p < 0.001).
- Median DFS differed significantly across LNR risk groups and pN stages.
- LNR provided additional prognostic information in specific subgroups, such as pN2 patients in the low-risk LNR group.
Conclusions:
- LNR is a significant prognostic factor for disease-free survival in early-stage breast cancer.
- LNR offers enhanced prognostic value compared to pathologic lymph node counts in select patient populations.
