J Breast Cancer.  2018 Sep;21(3):315-320. 10.4048/jbc.2018.21.e35.

Evaluating the Prediction of Breast Cancer Survival Using Lymph Node Ratio

• Hung M
• Xu J
• Nielson D
• Bounsanga
• Gu Y
• Hansen AR
• Voss MW

• KMID: 2421372
• DOI: http://doi.org/10.4048/jbc.2018.21.e35

Abstract

PURPOSE
Previous oncological studies showed that lymph node ratio (LNR) (ratio of number of lymph nodes that tested positive for metastasis to the total number of lymph nodes examined) is a negative indicator of cancer survival. The American Joint Committee on Cancer (AJCC) staging system incorporates tumor size, lymph node involvement, and metastasis in a comprehensive model of cancer progression, but LNR alone has been shown to outperform the AJCC system in prognostic and survival predictions for various types of cancer. The effectiveness of LNR has not been evaluated in breast cancer staging. Evaluating LNR for predicting cancer staging in breast cancer has the potential to improve treatment recommendations.
METHODS
The Surveillance, Epidemiology, and End Results dataset was used to identify 10,655 breast cancer patients who underwent nodal evaluation from 2010 to 2013, and their LNRs were calculated. Descriptive statistics of lymph node evaluation in the patients are provided. Logistic regression with LNR as the continuous independent variable was conducted to determine whether LNR could predict cancer progression, coded as regional or distant. Analysis was conducted using SPSS version 24.
RESULTS
Patient's mean age was 59.43±18.62. Logistic regression analysis revealed that for every 1.3% increase in LNR, the odds of falling into the distant stage of the TNM staging system increased by 13.7% (odds ratio, 14.73; 95% confidence interval, 12.00-18.08).
CONCLUSION
LNR, while correlated with breast cancer staging, serves as a better predictor of survival. Precision staging can influence treatment modality, and improved treatments can significantly improve quality of life. Additional research and diagnostic examinations using LNR as a potential tool for accurate staging in breast cancer patients are warranted.

Keyword

American Joint Committee on Cancer; Breast neoplasms; Lymph node; Neoplasm staging; Survival

MeSH Terms

Falling
Breast Neoplasms*
Breast*
Dataset
Epidemiology
Humans
Logistic Models
Lymph Nodes*
Neoplasm Staging
Quality of Life

Figure

• 

  Figure 1 Distribution of the Surveillance, Epidemiology, and End Results population for three progressions of breast cancer stage.

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