Prognosis for 10+ Positive Nodes
Posted 4/25/2010
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I know quite a few women who had ten or more positive lymph nodes at the time of diagnosis and are now, years later, doing just find. Unfortunately, that is not always the outcome, so I was pleased to see this report. It is safe to extrapolate from this study that prognosis has improved for everyone over the last decades.
Here is the abstract and then a link to read more of Basaran and colleagues study of women with ten or more positive lymph nodes. This is from Medical Oncology:
Clinical outcome of breast cancer patients with N3a (‡10 positive lymph nodes) disease: has it changed over years?
It has been shown that breast cancer patients with
N3a (10 positive lymph nodes) had a poor prognosis. We
planned to investigate the clinical outcome BC patients who
presented with N3a disease and had no evidence of systemic
metastasis at the time of diagnosis. We made a retrospective
chart review of breast cancer patients who had C10 positive
lymph nodes and received adjuvant systemic therapy in
Marmara University Hospital between 1998 and 2008. We
recorded clinical, pathologic and treatment characteristics of
the patients and analyzed the survival outcome. We identified
73 patients with N3a disease who were treated in Marmara
University Hospital between 1998 and 2008. The
median age was 52. Most (75%) of the patients had invasive
ductal histology, 75% had T2/T3 tumors, 36% had grade 3
tumors. The median number of metastatic lymph nodes was
15. Estrogen and progesterone receptors were both positive
in 61% and both negative in 16? tumors. Her-2/neu status
was assessed in 68% of the tumors; 18% of patients had 3?
and 50% had negative scores. Six patients had triple negative
tumors. All patients except one received adjuvant chemotherapy
and radiotherapy. Seventy-four percent of patients
received anthracycline/taxane-based chemotherapy. Fiftynine
patients received adjuvant endocrine therapy, 42% them
received aromatase inhibitors. Five of the 13 Her-2 positive
patients received adjuvant trastuzumab. With a median follow-
up of 47 months, 5-year disease and overall survival
rates were 66 and 81%, respectively. Twenty-four patients
had relapsed and 14 patients died. Her-2 status and the
number of lymph nodes (\20 vs.C20) had significant impact
on disease-free survival in the univariate analysis (P = 0.03
and 0.05, respectively) and Her-2 retained its significant
impact on disease-free survival in the multivariate analysis
(P = 0.05). The prognosis of BC patients with N3a disease
has changed favorably in the past decade with the current
standards of care.
http://tinyurl.com/257ho45
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