Abstract

Background and Objective: Prognosis is generally very poor in patients with breast cancer with 10 or more axillary node metastases, but long-term recurrence-free survival is observed. We assess the clinicopathological features of these patients with and without recurrent disease and review the literature. Patients and Methods: We retrospectively examined the background, clinicopathological features, and prognoses of 29 patients who underwent surgery at our hospital for primary breast cancer with 10 or more axillary lymph node metastases between April 2003 and March 2015 and compared findings between those with and without disease recurrence. Metastases were identified based on hematoxylin and eosin staining. Results: The mean number of lymph node metastases was 19 and of dissected lymph nodes, 26. The cumulative disease-free survival plateaued at 59% 3 years after treatment, and the cumulative overall survival rate was 68.4% at 5 years and plateaued at 61% at 6 years. The mean disease-free survival was significantly shorter in those whose disease recurred (13.6 months) than those without recurrence (62.2 months). The expression of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) differed significantly between the 2 groups. Conclusion: Prognosis is generally very poor in patients with breast cancer with 10 or more axillary node metastases if tumors recur within 3 years. Furthermore, findings of all five patients with recurrent disease demonstrating a triple-negative subtype and all 14 patients without recurrence demonstrating luminal A intrinsic subtype suggest the use of these subtypes as prognostic factors.

Keywords: Locally advanced breast cancer, Prognostic indicator,Tenor more metastases to axillary nodes