Prediction of prognosis in axillary lymph node positive breast cancer patients: A statistical study

1984 ◽  
Vol 71 (6) ◽  
pp. 459-462 ◽  
Author(s):  
B. O. Mæhle ◽  
R. Skjærven
2012 ◽  
Vol 19 (10) ◽  
pp. 3185-3191 ◽  
Author(s):  
Amy Cyr ◽  
Feng Gao ◽  
William E. Gillanders ◽  
Rebecca L. Aft ◽  
Timothy J. Eberlein ◽  
...  

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12090-e12090
Author(s):  
Wenyan Wang ◽  
Xin Wang ◽  
Xiang Wang ◽  
Jiaqi Liu ◽  
Pin Zhang

e12090 Background: Pathological complete response (pCR) of axillary lymph nodes (ALNs) is frequently achieved in patients with clinically node-positive breast cancer after neoadjuvant chemotherapy (NAC), and ALN status is an important prognostic factor for breast cancer patients. Our goal is to develop a new predictive clinical model to assess the axillary lymph node pCR rate after NAC. Methods: A retrospective series of 547 patients who had biopsy-proven positive ALNs at diagnosis and undergoing axillary lymph node dissection from 2007 to 2014 in National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences. We analyzed the clinicopathologic features and developed a nomogram to predict the probability of ALN pCR. Univariate assessment was performed using a logistic regression model. A multivariate logistic regression stepwise model was used to generate a nomogram to predict ALN pCR in node positive patients Variables with P < 0.05 on multivariable analysis were included in the nomogram. The adjusted area under the receiver operating characteristic curve (AUC) was calculated to quantify the ability to rank patients by risk. Internal validation was estimated using 50-50 hold out validation method. Nomogram was validated externally with the prospective cohort of 167 patients from 2016 to 2018. Results: In retrospective study, there were 172 (31.4%) patients achieved axillary pCR after NAC. Multivariate analysis indicated that clinical nodal (N) stage, hormone receptor (HR) status and clinical response of primary tumor after NAC were significant independent predictors for axillary pCR ( P< 0.05). The NAC nomogram was based on these three variables. In the internal validation of performance, the AUCs for the training and test sets were 0.719 and 0.753, respectively. The nomogram was validated in an external cohort with an AUC of 0.734. Conclusions: We developed a nomogram to predict the likelihood of axillary pCR in node positive breast cancer patients after NAC. The predictive model performed well in prospective external validation. This practical tool could provide information to surgeons regarding whether to perform additional ALND after NAC.


Author(s):  
Phuong Vo Van

Objectives: (1) Evaluate the efficacy of 4AC+4T regimen as adjuvant chemotherapy for stage II, IIIA breast cancer patients with axillary lymph node positive. (2) Describe toxicity of the regimen. Methods: Retrospective and prospective descriptive longitudinal study, in 39 stage II-III breast cancer patients with lymph node positive underwent modified radical mastectomy and axillary lymph node dissection, treated with 4AC + 4T regimen at Ha Tinh General Hospital from January 2013 to June 2019. Results: Overall survival was 83.6%. Disease-free survial was 75.6%. DFS and OS are inversely proportional to tumor size, the number of metastatic lymph nodes, ER and/PR positive have a better prognosis than ER/PR negative, stage II disease have better prognosis than stage IIIA (p<0.05). Toxicities of AC+4T: Leukopenia in 64.1% of patients, with 10,1% was grade 3, 4. Neutropenia in 61.5% of patients, with 7,6% was grade 3, 4. Hypopigmentation in 51.3% of patients, with 7,6% was grade 3, 4. Thrombocytopenia in 17.9% of patients. Transaminase elevation in 43.6% of patients, no seen grade 3, 4. Increased blood creatinine was only recorded at grade 1 at 5.1%. Vomiting and nausea 87%, stomatitis 30.8%, diarrhea 38.4%, muscle pain 87%, peripheral neuropathy 74.4% peripheral edema 38.5%. Conclusion: The 4AC + 4T regimen shows high efficacy and a acceptable toxicity in the treatment of stage II, IIIA breast cancer with axillary lymph node positive.


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