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

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

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Faculty of Medicine, Minia University, Minia, Egypt; Online Research Club, Nagasaki, Japan.
Online Research Club, Nagasaki, Japan; Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Online Research Club, Nagasaki, Japan; School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia.
Online Research Club, Nagasaki, Japan; Ho Chi Minh City Oncology Hospital, Ho Chi Minh City, Vietnam.
Online Research Club, Nagasaki, Japan; Al-Essra Hospital, Amman, Jordan.
Online Research Club, Nagasaki, Japan; University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Online Research Club, Nagasaki, Japan; Division of Infectious Disease, Department of Respiratory and Enteric Infections, International Center for Diarrheal Disease and Research, Dhaka, Bangladesh.
Evidence Based Medicine Research Group & Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam; Department of Clinical Product Development, Institute of Tropical Medicine, Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. Electronic address:



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.


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.


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).


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.


Breast; LN; MBC; NLR; SEER


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