Level of axillary involvement by lymph node metastases from breast cancer is not an independent predictor of survival
R. J. Barth Jr, D. N. Danforth Jr, D. J. Venzon, K. L. Straus, T. d'Angelo, M. J. Merino and L. Gerber
Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.
We examined the relationship of axillary level of lymph node metastases
from clinical stage I and II breast cancer to overall survival and
disease-free survival rates in 135 patients who underwent complete axillary
lymph node dissection to determine if anatomic level of axillary
involvement (I vs II vs III) is an independent prognostic factor. All
patients underwent either modified radical mastectomy or lumpectomy with
axillary dissection and whole breast radiotherapy for breast cancer. Median
follow-up was 6.9 years. We found no difference in overall survival or
disease-free survival between patients whose highest or only level of
axillary involvement was level I compared with patients whose highest or
only level was II. Although patients whose highest level of nodal
involvement was III had significantly worse overall survival and
disease-free survival rates than patients whose highest nodal involvement
was I or II, when patients were stratified by the total number of positive
nodes (one to three vs four or more), there was no difference in overall
survival or disease-free survival rates between levels I, II, and III.
These findings indicate that the level of axillary involvement for stage II
breast cancer is not of independent prognostic significance.
