The Prognostic Significance of Modified Lymph Node Ratio and LODDS in HER-2(+) Breast Cancer

Objective: The overexpression of human epidermal growht factor-2 (HER-2) receptor is detected in 20% of patients with breast cancer. The prognosis is poor in patients with HER-2(+) breast cancer not receiving systemic therapy. Modified lymph node ratio (mLNR) and log odds of positive lymph nodes (LODDS) are the novel ratio-based classifications of lymph nodes in breast cancer. In literatüre, the data about the prognostic significance of mLNR ve LODDS is limited in patients with HER-2(+) breast cancer. The objective of the study was to evaluate the prognostic significance of mLNR and LODDS in patients with HER-2(+) breast cancer. Method: This study included 75 patients who were treated with adjuvant chemotherapy and trastuzumab for the diagnosis of HER-2(+) breast cancer between 2008-2013. The patients who received neoadjuvant chemotherapy or patients without axillary dissection were excluded from the study. Results: The mean disease-free survival and overall survival were 126.36±4.38 months (range: 117.78-134.95) and 128.87±3.32 months (range: 122.37-135.38), respectively. The mean disease-free survival was 127.30 months in patients with mLNR≤ 0.5 and 118.08 months in patients with mLNR> 0.5 (p=0.690). When the patients were classified into three groups according to LODDS values as LODDS1 (LODDS≤ -1.0), LODDS2 (-1.0 0), the mean disease-free survival were 128.65 months, 114.07 months and 111.78 months, respectively (p=0.641). Conclusion: In this study, patients with HER-2(+) breast cancer were divided into risk groups according to mLNR and LODDS values, and a survival difference that could be clinically meaningful was observed between the groups, but was not statistically significant. There is a need for studies involving more patients on this subject. Our study highlights the prognostic significance of mLNR and LODDS in HER-2(+) breast cancer. Dividing HER-2(+) breast cancer into risk groups through mLNR and LODDS will help clinicians to develop optimal treatment and follow-up strategies.