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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2006

01-05-2006

Size of Residual Lymph Node Metastasis After Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer Patients Is Prognostic

Authors: Nancy Klauber-DeMore, MD, David W. Ollila, MD, Dominic T. Moore, M.S, M.P.H., Chad Livasy, MD, Benjamin F. Calvo, MD, Hong Jin Kim, MD, E. Claire Dees, MD, Carolyn I. Sartor, MD, Lynda R. Sawyer, M.F.A., Mark Graham II, MD, Lisa A. Carey, MD

Published in: Annals of Surgical Oncology | Issue 5/2006

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Abstract

Background

The prognostic significance of micrometastasis after neoadjuvant chemotherapy for locally advanced breast cancer is unknown. We examined the residual lymph node metastasis size in patients after treatment with neoadjuvant chemotherapy to determine the relevance of metastasis size on outcome.

Methods

Stage II/III breast cancer patients treated with neoadjuvant chemotherapy at our institution from 1991 to 2002 were included. We examined the relationship of postneoadjuvant chemotherapy lymph node metastasis size and number with distant disease-free survival (DDFS) and overall survival (OS).

Results

In 122 patients with a median follow-up of 5.4 years, we found not only that patients with an increasing number of residual positive nodes had progressively worse DDFS and OS (P < .0001 for both) compared with patients with negative nodes, but also that the size of the largest lymph node metastasis was associated with worse DDFS and OS (P < .0001 for both) in both univariate and multivariate analysis. Compared with negative nodes, even lymph node micrometastasis (<2 mm) was associated with worsened DDFS and OS (adjusted P = .02 and P = .005, respectively).

Conclusions

Residual micrometastatic disease in the axillary lymph nodes after neoadjuvant chemotherapy is predictive of worse prognosis than negative nodes. In this study, the lymph node metastasis size and the number of involved lymph nodes were independent powerful predictors of DDFS and OS.
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Metadata
Title
Size of Residual Lymph Node Metastasis After Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer Patients Is Prognostic
Authors
Nancy Klauber-DeMore, MD
David W. Ollila, MD
Dominic T. Moore, M.S, M.P.H.
Chad Livasy, MD
Benjamin F. Calvo, MD
Hong Jin Kim, MD
E. Claire Dees, MD
Carolyn I. Sartor, MD
Lynda R. Sawyer, M.F.A.
Mark Graham II, MD
Lisa A. Carey, MD
Publication date
01-05-2006
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 5/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2006.03.010

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