title: Prognostic Factors in Operated Stage IIIC, Pathological N3a Breast Cancer Patients.
abstract: BACKGROUND
  The aim of this retrospective study was to evaluate the prognostic factors in patients operated for stage IIIC breast carcinoma who had > 10 positive axillary lymph nodes (pN3a).
  
  
  METHODS
  The medical records of 302 operated N3a breast cancer patients without distant metastasis followed up in 2 medical oncology clinics in Ankara between January 1998 and June 2013 were evaluated retrospectively.
  
  
  RESULTS
  The median age was 50 (21-83) years. The median follow-up time was 43 (5-191) months. The patients were divided into 4 subgroups according to hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. There were 151 (50.0%) patients in the HR+/HER2- group, 80 (26.5%) patients in the HR+/HER2+ group, 42 (13.9%) patients in the HR-/HER2+ group, and 29 (9.6%) patients in the triple negative (TN) group. At the time of analysis, 155 (51.3%) patients had recurrent disease and 117 (38.7%) patients had died. The median disease-free survival (DFS) and overall survival (OS) times were 46.0 and 78.0 months, respectively. Both the DFS and OS in the HR+/HER2- group were longer than in the other groups (log-rank p = 0.034 and p = 0.016, respectively). Menopausal status, progesterone receptor (PgR) status, and lymph node ratio (LNR; defined as the number of positive lymph nodes compared to the total number of removed lymph nodes) were found to be independent prognostic factors (p = 0.019, p = 0.001, and p = 0.012, respectively).
  
  
  CONCLUSIONS
  Menopausal status, PgR status, and LNR were independent prognostic factors in operated N3a breast cancer patients, who are underrepresented in breast cancer trials.
authors.affiliation: Medical Oncology Department, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Turker
authors.affiliation: Medical Oncology Department, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Ulku Y
authors.initials: UY
authors.lastname: Arslan
authors.affiliation: Medical Oncology Department, Ankara Numune Training and Research Hospital, Turkey.
authors.forename: Ozan
authors.initials: O
authors.lastname: Yazici
authors.affiliation: Medical Oncology Department, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Ummugul
authors.initials: U
authors.lastname: Uyeturk
authors.affiliation: Medical Oncology Department, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Oksuzoglu
authors.affiliation: Medical Oncology Department, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Burcin
authors.initials: B
authors.lastname: Budakoglu
authors.affiliation: Medical Oncology Department, Ankara Numune Training and Research Hospital, Turkey.
authors.forename: Nuriye
authors.initials: N
authors.lastname: Özdemir
authors.affiliation: Medical Oncology Department, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
authors.forename: Ozlem U
authors.initials: OU
authors.lastname: Sonmez
authors.affiliation: Medical Oncology Department, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Kaan
authors.initials: K
authors.lastname: Helvaci
authors.affiliation: Medical Oncology Department, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Esbah
authors.affiliation: Medical Oncology Department, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Oznur
authors.initials: O
authors.lastname: Bal
authors.affiliation: Medical Oncology Department, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Ahmet S
authors.initials: AS
authors.lastname: Ekinci
authors.affiliation: Medical Oncology Department, Ankara Numune Training and Research Hospital, Turkey.
authors.forename: Nurullah
authors.initials: N
authors.lastname: Zengin
keywords: Breast cancer; Lymph node metastasis; Prognostic factor; Survival; Treatment strategies