A new perspective on the IIIC staging in Chinese patients with primary breast cancer: Single‑center experiences.

PURPOSE: The purpose of this retrospective study was to investigate whether Stage IIIC (TanyN3M0) breast cancer can be classified further into subgroups with different prognosis. MATERIALS AND METHODS: One hundred and thirty‑two patients with Stage IIIC breast cancer at Tianjin Medical University Cancer Institute and Hospital were analyzed. The disease‑free survival (DFS) and overall survival (OS) were calculated by Kaplan–Meier method for lymph node ratio (LNR) and the number of positive lymph node (PLN). The receiver operating characteristic curve analysis was performed to determine the optimal cut‑off value of the LNR and PLN. The univariate and multivariate analysis were applied to identify the prognostic factors. RESULTS: The results showed that the optimal cut‑off value of LNR value was 0.65, and the optimal cut‑off value of PLN was 15. The Kaplan–Meier survival analysis showed the higher value of LNR or PLN was correlated with shortened DFS (P = 0.002, P = 0.008, respectively) and OS (P < 0.001, P = 0.001, respectively). In multivariate survival analysis, the value of LNR and PLN were still remained as independent prognostic factors for DFS (P = 0.014, P = 0.013, respectively) and OS (P = 0.004, P = 0.002, respectively). CONCLUSION: These results suggest that the value of LNR or PLN could be used as a new significant prognostic biomarker for Stage IIIC breast cancer patients. Stage IIIC breast cancer patients with lower value of LNR or PLN may be down staged.