title: Nodal status and clinical outcomes in a large cohort of patients with triple-negative breast cancer.
abstract: OBJECTIVE
  To evaluate the clinical outcomes and relationship between tumor size, lymph node status, and prognosis in a large cohort of patients with confirmed triple receptor-negative breast cancer (TNBC).
  
  
  METHODS
  We reviewed 1,711 patients with TNBC diagnosed between 1980 and 2009. Patients were categorized by tumor size and nodal status. Kaplan-Meier product limit method was used to calculate overall survival (OS) and relapse-free survival (RFS). A Sidak adjustment was used for multiple group comparisons. Cox proportional hazards models were fit to determine the association of tumor size and nodal status with survival outcomes after adjustment for other patient and disease characteristics.
  
  
  RESULTS
  Median age was 48 years (range, 21 to 87 years). At a median follow-up of 53 months (range, 0.7 to 317 months), there were 614 deaths and 747 recurrences. The 5-year OS was 80% for node-negative patients (N0), 65% for one to three positive lymph nodes (N1), 48% for four to nine positive lymph nodes (N2), and 44% for ≥ 10 positive lymph nodes (N3; P < .0001). The 5-year RFS rates were 67% for N0, 52% for N1, 36% for N2, and 33% for N3 (P < .0001). Pairwise comparison by nodal status showed that when comparing N0 with node-positive disease, there was a significant difference in OS and RFS (P < .001 all comparisons). However, when comparing N1 with N2 and N3 disease regardless of tumor size, there were no significant differences in OS or RFS.
  
  
  CONCLUSIONS
  In patients with TNBC, once there is evidence of lymph node metastasis, the prognosis may not be affected by the number of positive lymph nodes.
authors: Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009, USA
authors: Leonel F
authors: LF
authors: Hernandez-Aya
authors: Mariana
authors: M
authors: Chavez-Macgregor
authors: Xiudong
authors: X
authors: Lei
authors: Funda
authors: F
authors: Meric-Bernstam
authors: Thomas A
authors: TA
authors: Buchholz
authors: Limin
authors: L
authors: Hsu
authors: Aysegul A
authors: AA
authors: Sahin
authors: Kim-Anh
authors: KA
authors: Do
authors: Vicente
authors: V
authors: Valero
authors: Gabriel N
authors: GN
authors: Hortobagyi
authors: Ana Maria
authors: AM
authors: Gonzalez-Angulo
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