PROGNOSTIC FACTORS IN PATIENTS WITH NODE-NEGATIVE BREAST-CANCER

Background: The overall prognosis of node-negative breast cancer patients is better than that of patients with metastatic nodes. Nevertheless, 25-30% of node-negative patients later on develop metastatic cancer. Definition of prognostic factors for better selection of those patients who would benefit from adjuvant systemic therapy is, therefore, of great importance. Patients and Methods: In 194 patients with operable breast cancer and negative lymph node status, the importance of different clinical and histological features with respect to survival was retrospectively and double-blindly investigated. Life table analysis, Cox regression analysis, and multivariate discrimination analysis were used for statistical evaluation. Results: Life table analysis showed the highly significant importance of vascular invasion (blood and lymph vessels) in comparison with grading for 10-year survival. Cox regression analysis showed vascular invasion as the only significant factor for long-term survival as did multivariate discrimination analysis which recognized menopause status and the paracortical zone of regional lymph nodes in 2nd and 3rd position of significance. Conclusions: Vascular invasion is a factor of great importance for long-term survival of node-negative breast cancer patients. It should be determined in a clinical study, whether the risk of metastatic cancer in patients with vascular invasion can be diminished by adjuvant systemic therapy and whether the prognosis of these patients can thus be improved.