Clinical Research Papers:

Effect of nodal status on clinical outcomes of triple-negative breast cancer: a population-based study using the SEER 18 database

Xiao-Xiao Wang, Yi-Zhou Jiang, Jun-Jing Li, Chuan-Gui Song _ and Zhi-Ming Shao

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Oncotarget. 2016; 7:46636-46645. https://doi.org/10.18632/oncotarget.9432

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Xiao-Xiao Wang1,*, Yi-Zhou Jiang2,*, Jun-Jing Li1,*, Chuan-Gui Song1, Zhi-Ming Shao2

1Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China

2Department of Breast Surgery, Key Laboratory of Breast Cancer, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China

*These authors have contributed equally to this work

Correspondence to:

Chuan-Gui Song, e-mail: [email protected]

Yi-Zhou Jiang, e-mail: [email protected]

Keywords: nodal status, tumor size, triple-negative breast cancer, breast cancer-specific survival, overall survival

Received: March 23, 2016     Accepted: April 27, 2016     Published: May 18, 2016


Triple-negative breast cancer (TNBC) is an aggressive malignancy with a poor prognosis. Data from the Surveillance, Epidemiology and End Results database (2010–2012) were used to identify 10,771 patients with TNBC, and we assessed the effects of lymph node (LN) status on breast cancer-specific survival (BCSS) and overall survival (OS). In our study, a Kaplan-Meier plot showed that LN-negative patients (N0) had better survival outcomes than LN-positive patients and that patients with ≥10 positive LNs (N3) exhibited the worst survival outcomes regardless of tumor size. A pairwise comparison showed no difference in survival outcomes among each group stratified by tumor size. Further, for LN-positive patients with a tumor size ≤2 cm (T1) or >5 cm (T3), there were similar outcomes between patients with one to three LNs (N1) and those with four to nine LNs (N2), whereas N1 patients experienced significantly better survival outcomes than N3 patients (P<0.001). Therefore, ten metastatic lymph nodes was the cut-off value for poor prognosis. Nevertheless, for patients with a tumor size of 2-5 cm (T2), the extent of LN involvement contributed prognostic value to OS but not BCSS. In summary, we found that nodal status and tumor size exhibited distinct interaction patterns for predicting the outcomes of TNBC. These results provide deeper insight into the prognostic value of nodal status in TNBC.

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