Objective: To analyze the relevance between lymph node status and pathological response after neoadjuvant chemotherapy and survival in breast cancer patients.
Methods: The clinicopathological data of 653 needle biopsy proved breast cancer patients, who underwent neoadjuvant chemotherapy and surgery in our hospital from July 1998 to April 2012, were retrospective analyzed.
Results: The median follow up time was 59.3 months. The 653 cases were classified into ypN0 (242 cases), ypN1 (182 cases), ypN2 (135 cases), and ypN3 (94 cases) stages, and the 5-year overall survival rates in the four groups were 93.4%, 93.4%, 87.4%, and 83.0%, respectively. The Log rank test showed a significant difference in the overall survival rates between the ypN0, ypN1, ypN2 stages and ypN3 stage (P=0.046). No significant differences were observed between the disease free survival (DFS) rates in the four groups (P>0.05). Multivariate analysis indicated that the postoperative pathological response of metastatic lymph nodes was a major prognostic factor affecting the overall survival and disease-free survival (RR=1.051, P=0.007; RR=1.028, P=0.028).
Conclusion: The stage and pathological response of axillary lymph nodes after neoadjuvant chemotherapy are effective indicators for predicting the OS and DFS in breast cancer patients.