Retrospective evaluation of breast cancer patients with five or more axillary lymph node involvement achieving 5-year overall survival

Year 2019, Volume: 5 Issue: 2, 268 - 273, 04.03.2019

Özlem Yersal , Mehmet Yiğit Nezih Meydan Sabri Barutca

https://doi.org/10.18621/eurj.368447

Abstract

Objectives: The aim of this study was to analyze high risk breast cancer patients with
involvement of five or more axillary lymph nodes with an overall survival of at
least five years, and to determine the predictive and prognostic factors by
comparing patients by recurrence/metastases status retrospectively.

Methods: From a total of 500 patients those were followed up in Adnan Menderes University,
Medical Oncology department, 37 were eligible for the study; 23 were disease
free and 14 had recurrence/metastases in the follow up period. The patients
were analyzed, for demographical (such as age, menopausal status, obesity),
anatomical and histological characteristics of tumor (primary tumor’s diameter,
stage, grade, Ki-67, hormon receptors and Her-2 status), treatment modalities
and prognosis.

Results: Both number of metastatic lymph nodes and
(metastatic/sampled) lymph node ratio were not significantly different between
the recurrence-free and metastatic patients. In the recurrence-free patients
both grade 3 (48% vs none, p = 0.03)
and p53 negative tumors (64% vs 36%, p
= 0.036) were significantly more than metastatic patients. Also in the recurrence
free patients as compared to metastatic patients, adjuvant chemotherapy was applied
more than 6 cycles (87% vs 43%, p = 0.004),
the regimens included more taxane based regimens (91% vs 64%, p = 0.042), aromatase inhibitors were
used higher (100% vs 75%, p = 0.019)
and the period of tamoxifen treatment in switch regimens were shorter.

Conclusion: The results of this study suggested that, high risk breast cancer patients with
involvement of five and more nodes that have the predictive factors as grade 3 and/or
p53 negative tumors are propably more responsive to adjuvant treatments. Chemotherapy
of more than 6 cycles, administering taxane based regimens and aromatase inhibitors
in the adjuvant regimens may favourably effect the prognosis.

Keywords

breast cancer, lymph node metastases, predictive and prognostic factors

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