Biomedicine

Abstract

Introduction and Aim: Axillary lymph node metastasis is a significant prognostic indicator in breast cancer patients. Lymph Node Ratio (LNR) is a better predictor of survival in node positive patients. We aimed to evaluate the prognostic significance of LNR in breast cancer patients. Materials and Methods: 643 breast cancer patients treated between January 2018 and December 2023 were analyzed retrospectively. LNR is calculated as ratio of number of positive lymph nodes and dissected nodes. Cut off value of LNR taken was 0.231 and patients were classified into low (=<0.231) and high (>0.231) LNR group. Survival outcomes were estimated by Kaplan Meier method while log rank test was used to assess the significance. Cox proportional hazard regression models were used for univariate and multivariate analysis of parameters associated with survival. Results: 49.6%(319) patients were found in high risk group. Adequate lymph nodes dissection (≥ 10) was found in 417/501 (83.2%) patients with Modified Radical Mastectomy (MRM) and in 104/135 (77.0%) patients with simple mastectomy with axillary dissection. The median number of lymph nodes dissected in adequate arm (n=526) was 13 (mean ± SD 13.90 ± 2.69, range 10-26). N3 nodal disease was significantly associated with positive perineural invasion (PNI). Median Disease Free Survival (DFS) in high risk group was 84 months, while it was not reached in the low risk arm. Conclusion: LNR is an independent predictive factor for the prognosis of DFS and OS for non-metastatic breast carcinoma. This observation should be tested in a larger study.