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September 5, 1977

Selection of Breast Cancer Patients for Adjuvant ChemotherapyAnother Look at the Prognostic Importance of Involved Lymph Nodes

JAMA. 1977;238(10):1034-1036. doi:10.1001/jama.1977.03280110038018

To aid in the selection of breast cancer patients for adjuvant chemotherapy, 263 patients with primary breast carcinoma undergoing curative surgery at the Yale-New Haven Medical Center were examined with respect to axillary lymph node involvement and prognosis.

Thirty-five percent of patients with one to three axillary nodes histologycally involved with cancer relapsed within five years, as did 61% of patients with four or more cancer-positive nodes. Equally important was the clinical stage. Stage III patients had a poor prognosis (71% relapse rate) regardless of their axillary status. Stage I patients with metastasis to one to three axillary nodes did just as well as stage I patients with no nodal involvement (13% relapse rate). Relapse rates within the nodal categories are significantly less (P <.05) than those reported by the National Surgical Adjuvant Breast Project.

(JAMA 238:1034-1036, 1977)