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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2011

Open Access 01-06-2011 | Breast Oncology

Prognostic Value of Lymph Node Micrometastases in Breast Cancer: A Multicenter Cohort Study

Authors: Paul D. Gobardhan, MD, Sjoerd G. Elias, MD, PhD, Eva V. E. Madsen, MD, Bob van Wely, MD, Frits van den Wildenberg, MD, Evert B. M. Theunissen, MD, PhD, Miranda F. Ernst, MD, PhD, Marike C. Kokke, MD, Carmen van der Pol, MD, Inne H. M. Borel Rinkes, MD, PhD, Jan H. Wijsman, MD, PhD, Vivian Bongers, MD, PhD, Joost van Gorp, MD, PhD, Thijs van Dalen, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2011

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Abstract

Background

To evaluate the prognostic meaning of lymph node micrometastases in breast cancer patients.

Methods

Between January 2000 and January 2003, 1411 patients with a cT1-2N0 invasive breast carcinoma underwent surgery in 7 hospitals in the Netherlands. Sentinel lymph node biopsy was done in all patients. Based on lymph node status, patients were divided into 4 groups: pN0 (n = 922), pN1micro (n = 103), pN1a (n = 285), and pN≥1b (n = 101). Median follow-up was 6.4 years.

Results

At the end of follow-up, 1121 women were still alive (79.4%), 184 had died (13.0%), and 106 were lost to follow-up (7.5%). Breast cancer recurred in 244 patients: distant metastasis (n = 165), locoregional relapse (n = 83), and contralateral breast cancer (n = 44). Following adjustment for possible confounding characteristics and for adjuvant systemic treatment, overall survival (OS) remained comparable for pN0 and pN1micro and was significantly worse for pN1a and pN≥1b (hazard ratio [HR] 1.18; 95% confidence interval [95% CI] 0.58–2.39, HR 2.47; 95% CI 1.69–3.63, HR 4.36; 95% CI 2.70–7.04, respectively). Disease-free survival (DFS) was similar too in the pN0 and pN1micro group, and worse for pN1a and pN≥1b (HR 0.96; 95% CI 0.56–1.67 vs HR 1.64; 95% CI 1.19–2.27, HR 2.95; CI 1.98–4.42). The distant metastases rate also did not differ significantly between the pN0 and pN1micro group and was worse for pN1a and pN≥1b (HR 1.22; 95% CI 0.60–2.49, HR 2.26; 95% CI 1.49–3.40, HR 3.49; CI 2.12–5.77).

Conclusions

In breast cancer patients survival is not affected by the presence of micrometastatic lymph node involvement.
Appendix
Available only for authorised users
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Metadata
Title
Prognostic Value of Lymph Node Micrometastases in Breast Cancer: A Multicenter Cohort Study
Authors
Paul D. Gobardhan, MD
Sjoerd G. Elias, MD, PhD
Eva V. E. Madsen, MD
Bob van Wely, MD
Frits van den Wildenberg, MD
Evert B. M. Theunissen, MD, PhD
Miranda F. Ernst, MD, PhD
Marike C. Kokke, MD
Carmen van der Pol, MD
Inne H. M. Borel Rinkes, MD, PhD
Jan H. Wijsman, MD, PhD
Vivian Bongers, MD, PhD
Joost van Gorp, MD, PhD
Thijs van Dalen, MD, PhD
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1451-z

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