The Effect of Receptor Status on Lymph Node Involvement and its Impact on the Survival of Breast Cancer Patients

Introduction & Breast cancer is known as the most common site-specific cancer as well as it is referred to as the second cause of mortality for women. Literature indicates that the most important prognostic factors are addressed by lymph node involvement, the activity of estrogen and progesterone receptors, tumor size, tumor grade, histologic type, and epidermal growth factor. Published researches address that these prognostic factors and the relationship between them are known as important indicators to assess the effectiveness of diagnosis of a treatment method and a treatment method influence of the breast cancer. However the published researches do not address analyzing the impact of the receptor status on lymph node involvement and the impact of the relationship between the prognostic factors on survival of patients with breast cancer. This study attempts to not only investigating the impact of the receptors on lymph node involvement, but also the survival of breast cancer patients considering simultaneously the receptor status and lymph node involvement prognostics, is analyzed.
In this study, 1822 patients diagnosed with breast cancer have been considered. These patients after treating in the period of 2007 till mid 2016 were cared under adjuvant therapy such as hormone therapy, chemotherapy and radiotherapy. In this study, receptor groups are defined in 8 categories based on different combinations, as well as the number of lymph nodes involvement are categorized in 4 branches (i.e. no lymph node involvement, between 1-3 lymph nodes involvement, between 4-9 lymph nodes involvement, and more than 9 lymph nodes involvement). Receptor statuses of these patients were analyzed using the logistic regression approach. In this research, the statistical software R has been used for data analysis.
The age mean (± Standard deviation) of the patients were addressed by 50.45 (±11.47) years. Lymph node involvement was recognized for more than half of the patients (933 people i.e. 51.20%). The frequency of each 8 receptor groups were obtained as (263 individuals) 14.43%, (222 individuals) 12.18%, (762 individuals) 41.82%, (138 individuals) 7.57%, (40 individuals) 2.19%, (70 individuals) 3.84%, (11 individuals) 0.54%, (22 individuals) 1.20%, respectively. Group 3 of the receptor status (i.e. simultaneous prognostics of positive estrogen, positive progesterone, and negative HER2), addressed the highest percentage of (762 individuals) 41.82%, and Group 7 (i.e. simultaneous prognostics of negative estrogen, positive progesterone, and HER2-positive) addressed the lowest percentage of (11 individuals) 0.54% among the other groups. P-value is addressed by 0.01 and 0.05 for estrogen and HER2, respectively, when the impact of receptors on lymph nodes has been analyzed.
This study indicated that: 1) there exist relationship between estrogen receptors and Her2 with lymph node involvement, so that these receptors impact on involving the lymph nodes. 2) In the case that the prognostics of positive estrogen, positive progesterone, and negative Her2 occur simultaneously, the receptor status addresses the best condition of the survival for a patient with breast cancer compared to other groups.