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Japanese Journal of Clinical Oncology, Vol 29, Issue 2 63-67, Copyright © 1999 by Foundation for Promotion of Cancer Research

ORIGINAL ARTICLE

The location of positive nodes partly influences the prognostic value of the number of positive nodes in breast cancer patients

Y Utada, F Kasumi, M Yoshimoto, T Tada, M Saitoh, K Takahashi, F Akiyama, G Sakamoto and M Nishi
Department of Breast Surgery, Cancer Institute, Tokyo, Japan.

BACKGROUND: The aim was to determine whether the number of positive lymph nodes or the location of lymph node metastasis (location number) would permit a more accurate prediction of prognoses. METHODS: We compared the survival rates of 3922 patients with primary breast cancer in relation to the location number and the number of positive lymph nodes. Survival rates were calculated by the Kaplan-Meier method and analyzed using the log rank test. RESULTS: Within the n1 alpha group, the presence of one or two positive nodes was associated with significantly better survival than the presence of three positive nodes. These groups should therefore be distinguished. Within the n1 beta group, there was no significant difference in survival between patients with four and those with seven or more positive nodes. Comparisons of n1 beta and n2 patients after subgrouping by the number of positive nodes (4-9 and 10 or more) revealed a significantly poorer prognosis in the n2 group. CONCLUSIONS: When the prognosis of breast cancer is considered from the viewpoint of lymph node metastasis, the location number as described in the General Rules is an excellent classification. However, we should be aware of possible differences in the prognosis depending on the number of positive nodes, as this is masked by the location number.
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