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Adjuvant chemotherapy may improve survival of patients with luminal A breast cancer and positive lymph nodes.

The study examined the clinicopathological characteristics and treatment options in patients with luminal A breast cancer. This retrospective cohort included 1580 patients with luminal A breast cancer treated between January 2005 and June 2007. Patients were divided into four subgroups according to lymph node status. Prognostic factors and 5-year overall survival (OS) and disease-free survival (DFS) of patients were analyzed. The median duration of follow-up was 67 months. Multivariate Cox-regression analysis revealed that patients in the LN2 and LN3 subgroups had a higher risk of recurrence and death than patients in the LN0 subgroup (LN2: HR = 2.2 for DFS and HR = 2.1 for OS; LN3: HR = 4.7 for DFS and HR = 4.7 for OS). In the LN2 subgroup, there was a trend towards reduced risk of recurrence and death for patients receiving adjuvant chemotherapy plus endocrine therapy, although this difference did not reach statistical significance. In the LN0 and LN1 subgroups, there was a trend towards an increased risk of death in patients receiving chemotherapy. Although lymph node status remains one of the most important independent prognostic predictors for luminal A breast cancer, in patients with 0-3 positive lymph nodes endocrine therapy can be considered sufficient. However, patients with ≥4 positive lymph nodes, and especially in those with ≥ 10, should receive chemotherapy.