Abstract 6-3-4

Background: The total number of axillary lymph nodes [LNs] is the most important prognostic factor in breast cancer. Over long times, different studies indicated that the lymph node ratio [LNR] might predict outcome better than the number of positive LNs. The aim of this retrospective study was to evaluate prognostic value of the lymph node ratio [LNR] in triple negative breast cancer [TNBC].

Materials and Methods: sixety patients with triple negative breast cancer [TNBC] at Zagazig University Hospitals and Fakous Cancer Center were included. We analyzed the impact lymph node ratio [LNR] on the disease free survival [DFS] and overall survival [OS] [calculated by Kaplan–Meier method].

Results: our results showed that the optimal cut off value of LNR value was 0.65, and the optimal cut off value of PLN. The Kaplan–Meier survival analysis showed the higher value of Mean disease free survival among all patients was 33.21 months and 3 year DFS was 50.6%. Disease free survival was significantly longer in those with LNR ≤ 0.65 than those with LNR > 0.65 [Mean: 33.34 months versus 27.46 months; 3year DFS 56.4% versus 36.9% respectively]. Mean overall survival among all patients was 36.90 months and 3 year OS was 50.4%. Overall survival was significantly longer in those with LNR ≤ 0.65 than those with LNR > 0.65 [Mean: 39.40 months versus 29.63 months; 3 year OS 73.8% versus 23.3% respectively].

Conclusion: These results suggest that TNBC patients with lower value of LNR good prognosis than with high LNR patients. The LNR is an independent prognostic factor, thus, LNR may be added to the current staging system.

Key Words: Triple-negative Breast cancer [TNBC], Lymph node ratio, Axillary lymph node,

____________________________________________________________________________

Acknowledgement

I would like to thanks the Debre zeit and Gondar Agricultural Research Center for providing seed samples and ICARDA for its financial, laboratory equipment and chemical support.

____________________________________________________________________________

Conflicts of interest: The authors stated that no conflicts of interest.

____________________________________________________________________________

Copyright: © 2018 | Author(s), This is an open access article under the terms of the Creative Commons Attribution-Non-Commercial - No Derives License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Ahn SH, Kim HJ, Lee JW, Gong GY, Noh DY, Yang JH, et al. (2011) Lymph node ratio and pN staging in patients with node-positive breast cancer: A report from the Korean breast cancer society. Breast Cancer Res Treat;130:507-15.

Chen SB, Weng HR, Wang G, Zou XF, Liu DT, Chen YP, et al. (2015) Lymph node ratio-based staging system for esophageal squamous cell carcinoma. World J Gastroenterol;21:7514-21.

Chen WQ, Zheng RS, Zhang SW, Zeng HM, Zou XN. ( 2014) The incidences and mortalities of major cancers in China, 2010. Chin J Cancer ;33:402-5

Coleman MP, Quaresma M, Berrino F, Lutz JM, De Angelis R,Capocaccia R, et al. (2008) Cancer survival in five continents: A worldwidepopulation-based study. Lancet Oncol ;9:730-56

Dogan B.E. & Turnbull L. W. (2012) Imaging of triple-negative breast cancer. Annals of Oncolog,23[Suppl. 6]: vi23–vi29,

Fernando LM ,Vector PS ,David SP.,et al; (2011) Tiple negative breast cancer in Hispanic patients., Cancer 117;3658-69.

Fulford LG, Reis-Filho JS, Ryder K et al. (2007) Basal-like grade III invasive ductal carcinoma of the breast: patterns of metastasis and long-term survival. Breast Cancer Res;9: R4.

Hatoum HA, Jamali FR, El-Saghir NS, et al. (2010) Ratio between positive lymph nodes and total excised axillary lymph nodes as an independent prognostic factor for overall survival in patients with nonmetastatic lymph node-positive breast cancer. Indian Surg Oncol ;1:305–12.

Kim JY, Ryu MR, Choi BO, et al. (2011) The prognostic significance of the lymph node ratio in axillary lymph node positive breast cancer. Journal of breast cancer;14:204-12

Kim MJ, Ro JY, Ahn SH et al. (2006) Clinicopathologic signiﬁcance of the basal-like subtype of breast cancer: a comparison with hormone receptor and Her2/neu- overexpressing phenotypes. Hum Pathol; 37: 1217–1226.

Kim SI, Cho SH, Lee JS, et al. (2013) Clinical relevance of lymph node ratio in breast cancer patients with one to three pos-itive lymph nodes. British journal of cancer;109:1165-71.

Lale Atahan I, Yildiz F, Ozyigit G, Sari S, Gurkaynak M, Selek U, et al. (2008) Percent positive axillary lymph node metastasis predicts survival in patients with non-metastatic breast cancer. Acta Oncol ;47:232-8.

Liao GS, Chou YC, Golshan M, Hsu HM, Hong ZJ, Yu JC, et al. (2015) Prognostic value of the lymph node ratio in breast cancer subtypes. Am J Surg;210:749-54.

Rizzo M, Lund MJ, Mosunjac M, Bumpers H, Holmes L, O'Regan R, et al. (2009) Characteristics and treatment modalities for African American women diagnosed with stage III breast cancer. Cancer ;115:3009-15.

Saxena N, Hartman M, Yip CH, Bhoo-Pathy N, Khin LW, Taib NA, et al. (2012) Does the axillary lymph node ratio have any added prognostic value over pN staging for South East Asian breast cancer patients? PLoS One ;7:e45809

Tausch C, Taucher S, Dubsky P, Seifert M, Reitsamer R, Kwasny W, et al. (2012) Prognostic value of number of removed lymph nodes, number of involved lymph nodes, and lymph node ratio in 7502 Group [ABCSG]. Ann Surg Oncol;19:1808-17

Tawfik R. ElKhodary, Mohamed A. Ebrahim, Elsayed E. Hatata and Nermeen A. Niazy. Prognostic value of lymph node ratio in node-positive Breast cancer in Egyptian patients. Journal of the Egyptian National Cancer Institute Journal of the Egyptian National Cancer Institute 26, 31–35.

Vinh-Hung V et al (2009) Lymph node ratio as an alternative topN staging in node-positive breast cancer. J Clin Oncol. 27[7]:1062–1068

Vinh-Hung V, Burzykowski T, Cserni G, Voordeckers M, Van De Steene J, Storme G. (2003) Functional form of the effect of the numbers of axillary nodes on survival in early breast cancer. Int J Oncol ;22: 697-704

Vinh-Hung V, Joseph SA, Coutty N, Ly BH, Vlastos G, NguyenNP. (2010) Age and axillary lymph node ratio in postmenopausal womenwith T1-T2 node positive breast cancer. Oncologist.;15:1050–62.

Vinh-Hung V, Nguyen NP, Cserni G, Truong P, Woodward W,Verkooijen HM, et al. (2009) Prognostic value of nodal ratios in nodepositivebreast cancer: a compiled update. Future Oncol.;5:1585–603.

Vinh-Hung V, Verkooijen HM, Fioretta G, Neyroud-Caspar I,Rapiti E, Vlastos G, et al. (2009) Lymph node ratio as an alternative to pN staging in node-positive breast cancer. J Clin Oncol.;27:1062–8.

Wang F, He W, Qiu H, Wang X, Guo G, Chen X, et al. (2012) Lymph node ratio and pN staging show different superiority as prognostic predictors depending on the number of lymph nodes dissected in Chinese patients with luminal A breast cancer. Clin Breast Cancer ;12:404-11

Zhu C, Wu XZ. Proposal of new classification for stage III breast cancer on the number and ratio of metastatic lymph nodes.(2012) J Surg Oncol ;106:696-702.