Clinical significance of the negative lymph node count after the axillary dissection of breast cancer patients.

Objective: The purpose of this study was to evaluate the impact of the negative lymph node (LN) count on the survival of the breast cancer patients in early stage after the axillary dissection. Methods: The breast cancer patients with TNM stage between January 2001 and December 2005 in Jiangsu Cancer Hospital, who underwent the axillary LNs dissection, were enrolled in this study. We analyzed the data of these patients including information of follow-up and postoperative pathological results. All patients were divided into two groups according to the axillary LN status and each group was divided into four subgroups according to the negative LN count. Cox regression analysis was performed to screen the pathological factor including the negative LN count on the survival and to compare the different negative LN count on the survival. Results: COX proportional hazard regression model showed that the survival of the breast cancer was significantly associated with the negative LN count. In TN group, when the negative LN count was 3 or less, 4 to 5, 6 to 9 and 10 or more, the median survival time was (82.6 ± 4.1) months, (101.5 ± 1.3) months, (104.7 ± 1.0) months, and (110.5 ± 0.9) months respectively ( P < 0.05). In TN group, when the negative LN count was 6 or less, 7 to 8, 9 to 10 and 11 or more, the median survival time was (95.4 ± 1.9) months, (101.8 ± 1.1) months, (104.9 ± 1.0) months, and (106.5 ± 0.9) months respectively ( P< 0.05). Conclusion: The negative LN count can reflect the adequacy of the axillary dissection. Increasing negative LN count is independently associated with improved survival in pTNM or pTNM staging breast cancer patients. The negative LN count should be considered for incorporation into staging for breast cancer with the axillary LN dissection. [ABSTRACT FROM AUTHOR]