title: Prognostic value of nodal ratios in node-positive breast cancer: a compiled update.
abstract: 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.
authors.affiliation: Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Vincent
authors.initials: V
authors.lastname: Vinh-Hung
authors.forename: Nam P
authors.initials: NP
authors.lastname: Nguyen
authors.forename: Gábor
authors.initials: G
authors.lastname: Cserni
authors.forename: Pauline
authors.initials: P
authors.lastname: Truong
authors.forename: Wendy
authors.initials: W
authors.lastname: Woodward
authors.forename: Helena M
authors.initials: HM
authors.lastname: Verkooijen
authors.forename: Donald
authors.initials: D
authors.lastname: Promish
authors.forename: Naoto T
authors.initials: NT
authors.lastname: Ueno
authors.forename: Patricia
authors.initials: P
authors.lastname: Tai
authors.forename: Yago
authors.initials: Y
authors.lastname: Nieto
authors.forename: Sue
authors.initials: S
authors.lastname: Joseph
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Janni
authors.forename: Frank
authors.initials: F
authors.lastname: Vicini
authors.forename: Melanie
authors.initials: M
authors.lastname: Royce
authors.forename: Guy
authors.initials: G
authors.lastname: Storme
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Wallace
authors.forename: Georges
authors.initials: G
authors.lastname: Vlastos
authors.forename: Christine
authors.initials: C
authors.lastname: Bouchardy
authors.forename: Gabriel N
authors.initials: GN
authors.lastname: Hortobagyi
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis