title: Clinical significance of lymph node ratio in locally advanced breast cancer molecular subtypes.
abstract: BACKGROUND
  The ratio of metastatic to dissected lymph nodes (lymph node ratio; LNR) is a sensitive and superior prognostic factor for lymph node evaluation, but its relationship to cancer subtypes is unclear.
  
  
  METHODS
  Data from 469 patients with axillary lymph node metastasis out of 640 early breast cancer cases were retrospectively analyzed. They were classified into 4 molecular subtypes; luminal A, luminal B HER2(+), HER2 overexpression, basal-like. LNRs were compared between groups and with other prognostic factors.
  
  
  RESULTS
  The distribution of LNRs was 35.2% in luminal A, 43.2% in luminal B HER2(+), 46.9% in HER2 over-expression, and 39.1% in basal-like. A significant difference was found between luminal A and HER2 over-expression subtypes (p = 0.023). LNR was significantly correlated with tumor size and lymphovascular invasion, but not with other prognostic factors including menopausal status, laterality, grade, and perineural invasion. An LNR of 29.8% was defined as the cut-off value, and significant differences in survival rates were identified accordingly between basal-like and both luminal A (p = 0.003) and luminal B HER2(+) (p = 0.04).
  
  
  CONCLUSIONS
  The LNR differs between some molecular subtypes of breast cancer, and it correlates with certain prognostic factors and survival. These data support using the LNR to assess breast cancer patients.
authors.affiliation: Rize Recep Tayyip Erdogan University Hospital, Department of Radiation Oncology, Rize, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Demircioglu
authors.forename: Umut
authors.initials: U
authors.lastname: Demirci
authors.forename: Diclehan
authors.initials: D
authors.lastname: Kilic
authors.forename: Secil
authors.initials: S
authors.lastname: Ozkan
authors.forename: Eray
authors.initials: E
authors.lastname: Karahacioglu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000556:secondary; D005260:Female; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone / Q000378:metabolism; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000706:statistics & numerical data*; D015996:Survival Rate; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone