Can axillary lymph node ratio (LNR) predict local recurrences or deaths in patients with breast cancer with nodal involvement?

Abstract

Background: Axillary LNR (Lymph Node Ratio) is increasingly been contended as an important prognostic factor in breast cancer with varying results. The purpose of this study was to evaluate LNR with respect to both local recurrences and deaths. Objective: To examine the value of the Lymph Node Ratio (LNR) in predicting local recurrence and death in breast cancer patients with lymph nodal involvement. Methods: This is a retrospective study on 150 patients treated for node-positive breast cancer in the University health board between 2013 and 2014. The LNR was defined as the number of positive Lymph Nodes (LNs) over the total number of LNs removed. The LNR-risk groups were defined as low-risk, 0.01-0.2; intermediate-risk, 0.21-0.65 and high-risk LNR>0.65. Results: The mean follow-up time was 3.6 y and mean age of diagnosis was 57 y. Moderate-and highrisk LNR was significantly associated with pN2 and pN3 classification, pT3 classification and grade 2 tumours compared to low-risk LNR. There were a total of 9 (6%) breast cancer local recurrences and 17 (11.3%) breast cancer deaths; grouped together as 26 (17.3%) 'Incidents' (recurrences/deaths). We found no significant difference between the incident rate and LNR group, pT classification, pN classification or age. Conclusion: Higher LNR-risk groups were associated with higher pN and pT classification; however LNR was not a good indicator of breast cancer recurrence and death.