Prognostic value of the lymph node ratio in breast cancer subtypes

•In this study, we evaluated the relationship between lymph node ratio (LNR) and overall survival•Comparing with traditional lymph node staging (pN) for the prediction of breast cancer prognosis.•We found that pN and LNR were important prognostic factors for patients with node-positive breast cancer•LNR has more predictive value for patients in luminal subtype breast cancer

BackgroundSeveral studies indicate that lymph node (LN) ratio (LNR) is more predictive than the traditional LN-positive stratification (pNs). We assessed whether LNR can provide additional prognostic information on node-positive breast cancer patients, particularly with breast cancer subtypes (BCS).MethodsWe retrospectively reviewed the medical records of 2,049 patients with primary breast cancer treated between January 2006 and December 2011 and identified 511 subjects with positive axillary LN. Clinicopathological findings, types of treatment, and the 5-year overall survival (OS) were included.ResultsThe results of multivariate analysis of the cohort showed that the correlations of pNs and LNR in regard to OS were P < .001 and P < .001, respectively, with adjustment for tumor characteristics and treatment factors. Moreover, our data revealed that LNR was more predictive in luminal A, luminal B, and luminal human epidermal growth factor receptor 2 in a comparison of pNs and LNR with regard to OS among BCS.ConclusionLNR and pNs are important prognostic factors with regard to OS for patients with node-positive breast cancer, but LNR has a more correlated value in BCS.