Identifying Prognostic Subgroups in Breast Cancer with Positive Lymph Nodes
Author Information
Author(s): Simon J Crabb, Chris D Bajdik, Samuel Leung, Caroline H Speers, Hagen Kennecke, David G Huntsman, Karen A Gelmon
Primary Institution: BC Cancer Agency
Hypothesis
Can clinically relevant prognostic subsets of breast cancer patients with four or more involved axillary lymph nodes be identified through immunohistochemical biomarkers?
Conclusion
Biomarkers assessed here carry independent prognostic value for breast cancer with four or more positive axillary nodes and identified clinically relevant prognostic subgroups.
Supporting Evidence
- 313 eligible patients were identified in the test set.
- 10-year relapse-free survival was 38.3%.
- Three prognostic subgroups were defined with mean 10-year relapse-free survivals of 75.4%, 35.3%, and 19.3%.
- Statistical significance was maintained in the validation set, though differences were less marked.
Takeaway
This study looked at breast cancer patients with many affected lymph nodes and found that certain biomarkers can help predict how well they might do.
Methodology
Patients with four or more positive axillary nodes were identified from a tissue microarray and randomized into a test set and a validation set, with a prognostic scoring model developed and assessed using various biomarkers.
Potential Biases
The study's reliance on historical data may introduce bias due to changes in treatment standards over time.
Limitations
The study cohort includes patients treated between 1986 and 1992, and treatment strategies have since evolved, which may affect the applicability of the findings.
Participant Demographics
The study included female patients diagnosed with invasive breast cancer without metastatic disease, with a focus on those having four or more positive axillary lymph nodes.
Statistical Information
P-Value
0.0005
Confidence Interval
95% CI 3.6 to 6.9
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website