Comparison of 10-Year Survival Between Patients With Axillary Pathologic Complete Response After Neoadjuvant...

We aimed to determine whether patients with cytologically proven node-positive disease who achieved axillary pathologic complete response (ypN0) after neoadjuvant chemotherapy (NAC) have similar survival outcomes to those with initially pathologically negative lymph nodes (pN0).

Patients with cytologically proven node-positive breast cancer who achieved ypN0 after NAC and those with pN0 between June 2005 and March 2012 in a large cancer hospital were reviewed. The relapse-free survival (RFS), distant-disease-free survival (DDFS) and overall survival (OS) of the 2 groups were calculated and compared.

A total of 2285 patients, including 183 patients with ypN0 and 2102 patients with pN0, were included in this study. The median follow-up time for patients was 121 (range 2-182) months. The 10-year cumulative RFS was 79.7% for ypN0 patients and 90.2% for pN0 patients (log-rank P < .001). The 10-year cumulative DDFS was 81.4% for ypN0 patients and 92.2% for pN0 patients (log-rank P < .001). The 10-year cumulative OS was 86.3% for ypN0 patients and 94.0% for pN0 patients (log-rank P < .001). The multivariable Cox proportional hazards models showed that compared with pN0 patients, ypN0 patients had a 2.00-fold increase in the risk of recurrence (HR = 2.00, 95% CI, 1.33-3.01, P = .001), a 2.34-fold increase in the risk of distant recurrence (HR = 2.34, 95% CI, 1.52-3.62, P < .001) and a 2.10-fold increase in the risk of death (HR = 2.10, 95% CI, 1.25-3.53, P = .005).

Patients with axillary pCR showed inferior RFS, DDFS and OS to patients with pN0.