title: Proposal of new classification for stage III breast cancer on the number and ratio of metastatic lymph nodes.
abstract: BACKGROUND
  The objective of the retrospective study was to confirm whether the current staging system of stage III was appropriate for breast cancer.
  
  
  METHODS
  Four hundred fifteen patients with breast cancer in stage III were analyzed. The survival analysis was performed by Kaplan-Meier.
  
  
  RESULTS
  Survival time of the patients with T1N3M0 was significantly better than the patients with other subgroups of stage IIIC (T2,3,4N3M0) and similar that of patients with T4N0,1,2M0 who formed the stage IIIB group based on pN stage. Tumor size, number of positive lymph nodes and lymph node ratio (LNR) were associated with overall survival (OS). The greatest survival difference was found when 0.60 as the cutoff point of LNR for the patients with current stage IIIC (pN3). rN1 included the patients in pN3 with LNR ≤ 0.60 and rN2 included the patients in pN3 with LNR >0.60. Survival time of the patients with T1,2,3,4N3(rN1)M0 and T1N3(rN2)M0 was differently better than the patients with T2,3,4N3(rN2)M0 and similar that of patients with T4N0,1,2M0.
  
  
  CONCLUSIONS
  We suggested current staging system should be modified combining pN with rN. We presumed the patients with T1N3M0 and T2,3,4N3(rN1)M0 disease were excluded from the current stage IIIC and included in stage IIIB group.
authors.affiliation: Department of Zhong-Shan-Men In-Patient, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
authors.forename: Cong
authors.initials: C
authors.lastname: Zhu
authors.forename: Xiong-Zhi
authors.initials: XZ
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000145:classification / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging