Long-Term Survival of Women with Locally Advanced Breast Cancer with ≥10 Involved Lymph Nodes at Diagnosis

Zeichner, Simon Blechman; Cavalcante, Ludimila; Suciu, Gabriel Pius; Ruiz, Ana Lourdes; Hirzel, Alicia; Krill-Jackson, Elisa

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자료유형: 학술저널

저자정보: Zeichner, Simon Blechman (Department of Internal Medicine, Mount Sinai Medical Center) Cavalcante, Ludimila (Department of Internal Medicine, Mount Sinai Medical Center) Suciu, Gabriel Pius (Department of Public Health and Biostatistics, Nova Southeastern University College of Osteopathic Medicine) Ruiz, Ana Lourdes (Department of Hematology and Oncology, Mount Sinai Medical Center) Hirzel, Alicia (Department of Pathology, Mount Sinai Medical Center) Krill-Jackson, Elisa (Department of Hematology and Oncology, Mount Sinai Medical Center)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제15권 제8호

발행연도: 2014.1

수록면: 3,435 - 3,441 (7page)

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Background: Axillary lymph node status at diagnosis remains the strongest predictor of long-term survival in breast cancer. Patients with more than ten axillary lymph nodes at diagnosis have a poor long-term survival. In this single institutional study, we set out to evaluate the prognosis of this high-risk group in the era of multimodality therapy. Materials and Methods: In this retrospective study, we looked at all breast cancer patients with greater than ten axillary lymph nodes diagnosed at Mount Sinai Medical Center (MSMC) from January 1st 1990 to December 31st 2007 (n=161). In the univariate analysis, descriptive frequencies, median survival, and 5- and 10-year survival rates were estimated for common prognostic factors. A multivariate prognostic analysis for time-to-event data, using the extended Cox regression model was carried out. Results: With a median and mean follow-up of 70 and 89.9 months, respectively, the overall median survival was estimated to be 99 months. The five-year disease-free survival (DFS) was 59.3% and the ten-year DFS was 37.9%, whereas the five- and ten-year overall survival (OS) was 66.6% and 43.9%, respectively. Multivariate analysis revealed a significant improvement in DFS among black patients compared to whites (p=0.05), improved DFS and OS among young patients (ages 21-45) compared to elderly patients (age greater than 70) (p=0.00176, p=0.0034, respectively), and improved DFS and OS among patients whose tumors were ER positive (p=0.049, p=0.0034). Conclusions: In this single institution study of patients with greater than 10 positive axillary nodes, black patients had a significantly improved DFS compared with white patients. Young age and ER tumor positivity was associated with improved outcomes. Using multivariate analysis, there were no other variables associated with statistically significant improvements in DFS or OS including date of diagnosis. Further work is needed to improve breast cancer survival in this subgroup of patients.

#Locally advanced breast cancer #greater than 10 nodes #breast cancer survival

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