Selection of breast cancer patients for adjuvant chemotherapy. Another look at the prognostic importance of involved lymph nodes
Packaud, R.A.; Prosnitz, L.R.; Bobrow, S.N.
JAMA 238(10): 1034-1036
1977
ISSN/ISBN: 0098-7484 PMID: 577942 Document Number: 115792
To aid in the selection of breast cancer patients for adjuvant chemotherapy, 263 patients with primary breast carcinoma undergoing curative surgery at the Yale-New Haven Medical Center were examined with respect to axillary lymph node involvement and prognosis. Thirty-five percent of patients with one to three axillary nodes histologically involved with cancer relapsed within five years, as did 61% of patients with four or more cancer-positive nodes. Equally important was the clinical stage. Stage III patients had a poor prognosis (71% relapse rate) regardless of their axillary status. Stage I patients with metastasis to one to three axillary nodes did just as well as stage I patients with no nodal involvement (13% relapse rate). Relapse rates within the nodal categories are significnatly less (P less than .05) than those reported by the National Surgical Adjuvant Breast Project.