Breast cancer remains one of the leading causes of cancer-related deaths among women globally. A recent retrospective cohort study conducted over three decades at the Cancer Research Center in Tehran, Iran, sheds light on the significant role of axillary lymph node (LN) status on the survival rates of patients afflicted with metastatic breast cancer.
With a total of 3,399 patients analyzed, the study explored the relationship between lymph node involvement and both disease-free survival (DFS) and overall survival (OS) metrics among breast cancer patients diagnosed between 1991 and 2022. Among participants, 49.1% had no axillary lymph node involvement, categorized as pN0, and these patients experienced the most favorable survival outcomes.
“Compared to pN0 group patients, those with any degree of axillary LN involvement had significantly higher hazards for recurrence,” stated the authors of the article. The study revealed key findings, highlighting how patients without positive lymph nodes have substantially lower recurrence risks compared to those with tumor involvement.
Among the patient cohort, significant variations were noted based on hormone receptor status. Specifically, the researchers observed positive estrogen and progesterone receptor statuses more frequently among pN0 patients. The hormone receptor statuses—estrogen receptor (ER), progesterone receptor (PR), and HER2—were found to play pivotal roles as predictors of LN involvement.
The results of the analysis indicated median follow-ups of 33 months for DFS and 38 months for OS, with pN0 patients recording the highest mean of DFS at 154 months compared to just 101 months for those with the most extensive LN involvement (pN3). Overall, 5-year DFS rates for pN0 patients were reported at 86%, illustrating the stark differences engendered by lymph node status.
The study authors emphasized the need for careful assessment and detection of lymph node involvement, which can significantly influence treatment strategies and patient outcomes. “Accurate detection of involved lymph nodes and close screening follow-up are of high value especially for patients with more metastatic LNs during surgery,” they noted.
This historically extensive research underlines the lasting importance of axillary lymph node status as one of the fundamental factors determining treatment prognosis for breast cancer patients, reinforcing clinical practices toward more cautious approaches such as avoiding unnecessary axillary lymph node dissections when indicated.
While the research possesses several strengths, it is not without limitations including its demographic focus and reliance on historical data, emphasizing the need for continued exploration across diverse populations and varying methodologies. Overall, the findings from this study serve to advance the current knowledge on breast cancer treatment and prognosis, highlighting the importance of personalized approaches based on individual axillary lymph node status.