Does Adjuvant Systemic Therapy Improve Prognosis in Breast Cancer with 4-9 Axillary Nodes and in the Age Group of 80 Years or More?

Background: The study was undertaken to evaluate the prognosis and prognostic factors of women with breast cancer under routine conditions. One of the main questions was to show, how prognosis is influenced by the adjuvant systemic therapy (CMF chemotherapy or hormonal therapy) with or without adjuvant radiotherapy in patients with breast cancer and positive axillary nodes (≥4). Patients and Methods: All patients (n =2,802) with primary breast cancer treated at the Oncology Center of Stuttgart, between 1988 and mid 1994, were retrospectively evaluated. Results: Patients with 4 or more nodes involved receiving adjuvant systemic therapy had an equal prognosis, compared to patients with 1–3 axillary nodes. After further analysis, a benefit was observed only among patients with 4–9 nodes involved, but not among patients with 10 or more axillary nodes. Conclusions: In the retrospective evaluation of data of groups not well-matched, the results have to be interpreted carefully. Bearing this in mind, the data nevertheless indicate that the prognosis of patients with 4–9 nodes involved is not so bad as it has been published, when they are treated with adjuvant systemic therapy with radiotherapy. Furthermore, the data indicate that adjuvant systemic treatment helps to prolong survival time in patients aged 80 years or more.