Prognostic value of nodal ratios in node-positive breast cancer: a compiled update.
The number of positive axillary nodes is a strong prognostic factor in breast cancer, but is affected by variability in nodal staging technique yielding varying numbers of excised nodes. The nodal ratio of positive to excised nodes is an alternative that could address this variability. Our 2006 review found that the nodal ratio consistently outperformed the number of positive nodes, providing strong arguments for the use of nodal ratios in breast cancer staging and management. New evidence has continued to accrue confirming the prognostic significance of nodal ratios in various worldwide population settings. This review provides an updated summary of available data, and discusses the potential application of the nodal ratio to breast cancer staging and prognostication, its role in the context of modern surgical techniques such as sentinel node biopsy, and its potential correlations with new biologic markers such as circulating tumor cells and breast cancer stem cells.
Vinh-Hung
Vincent
V
Geneva University Hospitals, Geneva, Switzerland.
Nguyen
Nam P
NP
Cserni
Gábor
G
Truong
Pauline
P
Woodward
Wendy
W
Verkooijen
Helena M
HM
Promish
Donald
D
Ueno
Naoto T
NT
Tai
Patricia
P
Nieto
Yago
Y
Joseph
Sue
S
Janni
Wolfgang
W
Vicini
Frank
F
Royce
Melanie
M
Storme
Guy
G
Wallace
Anne-Marie
AM
Vlastos
Georges
G
Bouchardy
Christine
C
Hortobagyi
Gabriel N
GN
D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis