A High Number of Tumor Free Axillary Lymph Nodes from Patients with Lymph Node Negative Breast Carcinoma is Associated with Poor Outcome

Robert L. Camp, Eric B. Rimm, David L. Rimm
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 1, 2001

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Reviewers: Li Liu, MD
Source: Cancer, Volume 88:108-113, (January) 2000

Précis: Total number of lymph nodes predicts outcome of node-negative breast cancer


The histologic status of axillary lymph nodes is one of the most important prognostic indicators in patients with breast cancer. However, for patients with negative axillary lymph nodes, the relationship between the total number of lymph nodes removed at the time of surgery and clinical outcome remains unknown. In this study, the researchers investigated this specific issue.


The number of lymph nodes in 290 patients with node-negative breast carcinoma who underwent axillary dissection was assessed. The patients were followed for a median period of 103 months.


  • Patients with 20 lymph nodes or more were 4.33 times more likely than those with fewer lymph nodes to die of metastatic breast carcinoma within 5 years.
  • The 5-year survival rate was 84.7% for patients with 20 or more lymph nodes and 95.3% for those with fewer.


In this study, a high number of lymph nodes was associated with aggressive disease in patients with node-negative breast carcinoma and may indicate that the tumor is inducing lymphangiogenesis. The next step would be to determine exactly what the factors are that produce lymphatic proliferation. Are they tumor-produced or is it due to the body's response to the tumor?


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