Selection of breast cancer patients for adjuvant chemotherapy. Another look at the prognostic importance of involved lymph nodes

R. A. Packaud, L. R. Prosnitz and S. N. Bobrow

To aid in the selection of breast cancer patients for adjuvant chemotherapy, 263 patients with primary breast carcinoma undergoing curative surgery at the Yale-New Haven Medical Center were examined with respect to axillary lymph node involvement and prognosis. Thirty-five percent of patients with one to three axillary nodes histologically involved with cancer relapsed within five years, as did 61% of patients with four or more cancer-positive nodes. Equally important was the clinical stage. Stage III patients had a poor prognosis (71% relapse rate) regardless of their axillary status. Stage I patients with metastasis to one to three axillary nodes did just as well as stage I patients with no nodal involvement (13% relapse rate). Relapse rates within the nodal categories are significnatly less (P less than .05) than those reported by the National Surgical Adjuvant Breast Project.