The natural history of breast carcinoma in patients withor = 10 metastatic axillary lymph nodes before and after the advent of adjuvant therapy: a multiinstitutional retrospective study.

BACKGROUND The majority of patients with breast carcinoma with ≥ 10 metastatic axillary lymph nodes (ALNs) develop recurrent disease within 5 years from diagnosis. The purpose of the current study, performed retrospectively, was to characterize the natural history of this subset of patients, both before and after the advent of adjuvant anthracycline-based chemotherapy and tamoxifen. METHODS Retrospectively, patients with primary breast carcinoma (N = 882) with ≥ 10 metastatic ALNs, treated between 1954 and 1998, were selected from 3 institutions: The University of Texas M. D. Anderson Cancer Center (Houston, TX); the Institut Gustave Roussy (Villejuif, France); and Hospital Clinico Universi…