Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases

Abstract

Two of the most important prognostic indicators for breast cancer are tumor size and extent of axillary lymph node involvement. Data on 24,740 cases recorded in the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute were used to evaluate the breast cancer survival experience in a representative sample of women from the United States. Actuarial (life table) methods were used to investigate the 5-year relative survival rates in cases with known operative/pathologic axillary lymph node status and primary tumor diameter. Survival rates varied from 45.5% for tumor diameters equal to or greater than 5 cm with positive axillary nodes to 96.3% for tumors less than 2 cm and with no involved nodes. The relation between tumor size and lymph node status was investigated in detail. Tumor diameter and lymph node status were found to act as independent but additive prognostic indicators. As tumor size increased, survival decreased regardless of lymph node status; and as lymph node involvement increased, survival status also decreased regardless of tumor size. A linear relation was found between tumor diameter and the percent of cases with positive lymph node involvement. The results of our analyses suggest that disease progression to distant sites does not occur exclusively via the axillary lymph nodes, but rather that lymph node status serves as an indicator of the tumor's ability to spread.

Quantitation of the Regional Lymph Node Metastatic Burden and Prognosis in Malignant Mammary Tumors of Dogs

“…To our knowledge, this study is the first to describe the prognostic significance of identifying a higher number of lymph nodes positive for metastasis in dogs, as has been reported in humans 1, 39. Another novel aspect is the use of a more accurate technique for measuring metastases, which yields a more detailed representation of the metastatic load of the lymph nodes in these animals.…”

“…This parameter may become an important prognostic factor in veterinary clinical practice and has not previously been described in dogs. In women, a higher number of affected axillary lymph nodes is associated with shorter survival times, which is a well‐recognized prognostic factor in breast cancer 1, 39…”

“…In human medicine, axillary lymph node status is an important prognostic factor for women with breast cancer 1. Sentinel lymph node (SLN) biopsy is the current standard of care for staging the clinically negative axilla in breast cancer patients, with axillary lymph node dissection reserved for patients with clinical axillary metastases or metastases found on SLN biopsy 2, 3.…”

Survivin is an independent predictor of short-term survival in poor prognostic breast cancer patients

“…For the management of individual patients there is a need to have markers that can identify those cancers likely to have a better or a worse prognosis (prognostic) and also aid the selection of appropriate therapy (predictive) (Gelber et al, 2003;Hayes, 2003). Clinico-pathological factors such as tumour size, node status and tumour grade are acknowledged important prognostic factors (Carter et al, 1989;Elston and Ellis, 1991;Henson et al, 1991;Galea et al, 1992;Gebauer et al, 2002). Oestrogen receptor (ER) status has been used for many years for the selection of those patients who are more likely to benefit from hormone treatment, either for metastatic disease (Elledge et al, 2000) or as adjuvant therapy (Harvey et al, 1999).…”

Correlation of Levels of IL-6 with Tumor Burden and Receptor Status in Patients of Locally Advanced Carcinoma Breast

“…As axillary lymph node involvement is most important prognostic factor [15], this relationship inspires confidence in suggesting IL-6 levels as prognostic factors further. So serum IL-6 levels may be used in those patients who are node negative for an individualized assessment and use of systemic therapy.…”