Selection of breast cancer patients for adjuvant chemotherapy. Another look at the prognostic importance of involved lymph nodes

Abstract

To aid in the selection of breast cancer patients for adjuvant chemotherapy, 263 patients with primary breast carcinoma undergoing curative surgery were examined with respect to axillary lymph node involvement and prognosis. Thirty-five percent of patients with 1-3 axillary nodes histologically involved with cancer relapsed within 5 yr as did 61% of patients with 4 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 metastases to 1-3 axillary nodes did as well as stage I patients with no nodal involvement (13% relapse rate). Relapse rates within the nodal categories are significantly less (P < .05) than those reported by the National Surgical Adjuvant Breast Project.