Clinical Outcomes and Prognostic Factors of Pathologic N3 Breast Cancer Treated With Modern Standard Treatments

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• 作者：Jeong Il Yu¹ ; Won Park¹ ; ^{wonro.park@samsung.com" class="auth_mail" title="E-mail the corresponding author} ; Doo Ho Choi¹ ; Seung Jae Huh¹ ; Seok Jin Nam² ; Seok Won Kim² ; Jeong Eon Lee² ; Won Ho Kil² ; Young-Hyuck Im³ ; Jin Seok Ahn³ ; Yeon Hee Park³ ; Eun Yun Cho⁴
• 关键词：Breast cancer ; N3 ; Prognosis ; Prognostic factor ; Recurrence
• 刊名：Clinical Breast Cancer
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：15
• 期：6
• 页码：512-518
• 全文大小：491 K

文摘

The aim of the present study was to investigate clinical outcomes and identify prognostic factors in pathologic N3 (pN3) breast cancer patients who received the current standard management.

Patients and Methods

We performed a retrospective study with 333 pN3 breast cancer patients who received curative surgery with postoperative radiation therapy and taxane-based adjuvant chemotherapy from January 2000 to June 2012. The median follow-up period was 58.3 months (range, 7.4-167.9 months). All of the 243 patients who were hormone receptor-positive received endocrine therapy, and trastuzumab therapy was used in 63 of 88 (71.6%) HER2-positive patients.

Results

Overall, 112 disease recurrences (33.6%) were documented during the follow-up. The first site of recurrence was locoregional in 21 patients (6.3%), distant metastases in 72 patients (21.6%), and both in 19 patients (5.7%). The disease-free survival (DFS) and overall survival were 63.3% and 86.9% at 5 years, respectively. DFS was significantly related to age (> 40 years; P = .008; hazard ratio [HR], 0.59; 95% confidence interval [CI], 0.40-0.87), nuclear grade (I or II; P = .02; HR, 0.64; 95% CI, 0.44-0.93), and positive lymph node ratio (≤ 60%; P = .004; HR, 0.56; 95% CI, 0.38-0.83) in multivariate analysis. HER2-positive patients who were treated with trastuzumab showed more favorable DFS than HER2-negative patients.

Conclusion

More than 60% of the pN3 breast cancer patients treated with the current standard management lived without disease longer than 5 years. Age, nuclear grade, and lymph node ratio were significant prognostic factors in pN3 breast cancer patients.