ABSTRACT
ObjectiveThe number of positve axillary lymph nodes(ALNs) is one of the most important factors affecting prognosis of patients with breast cancer.The resected lymph nodes number( LNN)can affect the number of positive ALNs.In this study,we aim to evaluate the influence of LNN on the progonosis of breast cancer patients with positive ALNs.Methods449 breast cancer patients with positive ALNs who underwent total mastectomy and axillary dissection were divided into 2 groups:group A (LNN ＜ 10)and group B (LNN ≥ 10).The clinicopathological features of the 2 groups were compared.Kaplan-Meier method and Cox proportional hazard method were respectively used to make univariate and multivariate survival analysis for disease-free survival (DFS).ResultsThe median follow-up was 43.59 months for group A and 41.34 months for group B.Group A had a significantly higher proportion of patients in pN1,with lymph node metastasis and adjuvant radiotherapy than group B.Univariate analysis showed pN stage,LNN,lymph nodes metastasis rate,HER-2,adjuvant chemotherapy regime and adjuvant radiotherapy were factors influencing DFS. Multivariate analysis showed that pN stage,LNN,lymph nodes metastasis rate,adjuvant chemotherapy regime and adjuvant radiotherapy were factors influencing DFS.We performed analysis stratified by adjuvant chemotherapy regime containing taxan and adjuvant radiotherapy.Stratified analysis showed patients with adjuvant chemotherapy regime containing taxus and adjuvant radiotherapy showed significantly higher DFS rate than those without taxus in adjuvant chemotherapy regime or without adjuvant radiotherapy in group A.However,the 2 different treatment regime had no difference in DFS rate for patients in group B.ConclusionsThe decrease of LNN may affect the diagnosis and therapeutic selection of breast cancer patients with positive ALNs.LNN is an inexpensive and easily available factor for predicting DFS of breast cancer patientswithpositiveALNs.Adjuvant chemotherapy regime containing taxus and adjuvant radiotherapy can improve DFS rate of patients with LNN ＜ 10.