Negative Lymph Node Count and Lymph Node Ratio Are Associated With Survival in Male Breast Cancer

Clin Breast Cancer. 2018 Dec;18(6):e1293-e1310. doi: 10.1016/j.clbc.2018.07.003. Epub 2018 Jul 7.


Background: Male breast cancer (MBC) is usually diagnosed at late stages and therefore has a worse prognosis than female breast cancer (FBC). MBC is also more likely to have lymph node (LN) involvement than FBC.

Materials and methods: We sought to determine the prognostic role of the examined lymph node (LN), negative LN (NLN), and positive LN counts and the LN ratio (LNR), defined as (positive LNs/ENLs), on the survival rate among MBC patients. We performed a large population-based study using the data from the Surveillance, Epidemiology, and End Results program.

Results: Older age, black race, stage IV disease, ≤ 1 NLN, and a > 31.3% LNR were significantly associated with worse survival across all prediction models. Moreover, we demonstrated a decreased risk of mortality in MBC patients across the MBC-specific survival model (hazard ratio, 0.98; 95% confidence interval, 0.96-0.998; P = .03) and 10-year MBC-specific survival model (hazard ratio, 0.98; 95% confidence interval, 0.96-0.999; P = .04).

Conclusion: MBC has had an augmented incidence over the years. We found several independent predictors of MBC survival, including age, race, stage, NLNs, and the LNR. We strongly suggest adding the NLN count and/or LNR into the current staging system. Further studies are needed to provide information on the mechanisms underlying the association between the NLN count and MBC survival and the LNR and MBC survival.

Keywords: Breast; LN; MBC; NLR; SEER.

MeSH terms

  • Breast Neoplasms, Male / mortality*
  • Breast Neoplasms, Male / pathology
  • Breast Neoplasms, Male / surgery
  • Follow-Up Studies
  • Humans
  • Lymph Node Excision / mortality*
  • Lymph Nodes / pathology*
  • Lymph Nodes / surgery
  • Male
  • Middle Aged
  • Prognosis
  • SEER Program
  • Survival Rate