Background: Axillary lymph node (LN) status is one of the most significant prognostic markers in breast cancer, many studies show that LN ratio (LNR) has been shown to outperform N staging in survival prediction.
Aim of the Work: To assess the impact of lymph node ratio (LNR) on the disease free survival (DFS), overall survival (OS) and pattern of recurrence among the study group (non metastatic, triple negative patients treated with upfront surgery).
Patients and Methods: A retrospective analysis of 42 female patients with non metastatic triple negative breast cancer treated with up front surgery from January 2016 and January 2019 at the breast unit, clinical oncology department, Ain shams university. to evaluate prognostic value of the lymph node ratio (LNR) in these patients.
Results: In this analysis there was statistical significant difference in the primary endpoint of DFS between group I with LNR <0.2 and group II with LNR≥0.20 [Mean: 43.843months versus23.781 months; 3year DFS 68% versus 29.4% respectively]. P = 0.0049, although there was no statistical significant difference between these two groups in OS [Mean: 48.664 months versus37.531 months; 3year OS 78.6%versus65.4% respectively] P = 00.2618. Also, there was statistical significant increase risk of recurrence at group II with LNR≥0.20 more than group I with LNR <0.2 [60% versus 40% respectively] P = 0.0152. On the other hand, ypN staging was not associated with PFS or OS where mean OS of N1&N2-3 (46 months versus 42.3 months respectively) p=0.8005 and mean OS of N1&N2-3 (46 months versus 42.3 months respectively) p=0.8005
Conclusion: The lymph node ratio (LNR) is a better prognostic factor of survival than N staging in non metastatic triple breast cancer patients and it may be accurate marker for staging of axillary nodes to evaluate of the prognosis in the clinical setting.