title: A new perspective on the IIIC staging in Chinese patients with primary breast cancer: Single-center experiences.
abstract: OBJECTIVE
  The purpose of this retrospective study was to investigate whether Stage IIIC (TanyN3M0) breast cancer can be classified further into subgroups with different prognosis.
  
  
  METHODS
  One hundred and thirty-two patients with Stage IIIC breast cancer at Tianjin Medical University Cancer Institute and Hospital were analyzed. The disease-free survival (DFS) and overall survival (OS) were calculated by Kaplan-Meier method for lymph node ratio (LNR) and the number of positive lymph node (PLN). The receiver operating characteristic curve analysis was performed to determine the optimal cut-off value of the LNR and PLN. The univariate and multivariate analysis were applied to identify the prognostic factors.
  
  
  RESULTS
  The results showed that the optimal cut-off value of LNR value was 0.65, and the optimal cut-off value of PLN was 15. The Kaplan-Meier survival analysis showed the higher value of LNR or PLN was correlated with shortened DFS (P = 0.002, P = 0.008, respectively) and OS (P < 0.001, P = 0.001, respectively). In multivariate survival analysis, the value of LNR and PLN were still remained as independent prognostic factors for DFS (P = 0.014, P = 0.013, respectively) and OS (P = 0.004, P = 0.002, respectively).
  
  
  CONCLUSIONS
  These results suggest that the value of LNR or PLN could be used as a new significant prognostic biomarker for Stage IIIC breast cancer patients. Stage IIIC breast cancer patients with lower value of LNR or PLN may be down staged.
authors.forename: Z H
authors.initials: ZH
authors.lastname: Yu
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Yang
authors.forename: Q
authors.initials: Q
authors.lastname: Chen
authors.forename: F
authors.initials: F
authors.lastname: Xing
authors.forename: B
authors.initials: B
authors.lastname: Zhang
authors.affiliation: The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital; Key Laboratory of Cancer Prevention and Therapy; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China.
authors.forename: X C
authors.initials: XC
authors.lastname: Cao
mesh_terms: D044466:Asian People; D001943:Breast Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D012189:Retrospective Studies