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目的确定具有高危复发转移倾向的病人．给他们实施积极而合理的治疗，以改善他们的预后。方法回顾性地分析了188例脏窝淋巴结阳性，术后接受CMFVP辅助化疗的Ⅰ、Ⅱ期乳癌病人。观察的终点指标为5年无病生存率（DFS）和总生存率（OS）。考虑分析的因素包括年龄、月经状态、病程、原发肿瘤大小、雌激素受体状态、阳性腑窝淋巴结数量。结果对DFS和OS有预后意义的两个因素是原发肿瘤大小和阳性腋窝淋巴结数量。传统的T1和T2之间比较，预后无明显差别。但把肿瘤的大小由2cm改为3cm为观察界限，肿瘤的大小将是非常明显的预后因素。T≤3cm的病人的5年DFS和OS分别是71．3％和83．2％，而T＞3cm的病人5年DFS和OS分别是48．3％（P＜0．01）和62．6％（P＜0．01）。将这两个不良的预后因素按T＞3cm和N＋≥4把病人分成三组，Ⅰ组是没有以上两个因素；Ⅱ组是只有其中一个不良的因素；Ⅲ组是同时具有两个不良因素。三组病人的5年DFS分别为78．3％、59．2％、28．4％（P＜0．05）。5年OS分别为86．2％、74．3％、40．0％（P＜0．05）。结论我们的分析证实了传统预后指标的意义，同时也发现，肿瘤直径＞3cm是一个不良的预后因素，它不依赖于阳性淋巴结的数目．这提示我们在设计和分析临床试验，确定病人治疗措施时应充分
Objective To determine patients with high risk of relapse and metastasis. Give them positive and reasonable treatment to improve their prognosis. Methods A retrospective analysis of 188 patients with positive lymph node nodes and stage I and II breast cancer patients who underwent CMFVP adjuvant chemotherapy was performed. The end point indicators observed were 5-year disease-free survival (DFS) and overall survival (OS). Factors considered for analysis included age, menstrual status, duration of disease, primary tumor size, estrogen receptor status, and positive axillary lymph node counts. Results Two factors with prognostic significance for DFS and OS were primary tumor size and positive axillary lymph node numbers. There is no significant difference in the prognosis between the traditional T1 and T2. However, changing the size of the tumor from 2cm to 3cm is the limit of observation, and the size of the tumor will be a very significant prognostic factor. The 5-year DFS and OS of patients with T ≤ 3cm were 71.3% and 83.2%, respectively, while those with T> 3cm were 48.3% at 5 years of DFS and OS (P < 0.01) and 62. 6% (P<0.01). The two unfavorable prognostic factors were divided into three groups according to T>3cm and N+≥4. There was no such two factors in Group I; Group II was only one of the adverse factors; Group III was also associated with two adverse factors. . The 5-year DFS of the three groups was 78.3%, 59.2%, and 28.4% (P<0.05). The 5-year OS was 86.2%, 74.3%, and 40.0%, respectively (P<0.05). Conclusion Our analysis confirmed the significance of traditional prognostic indicators. It was also found that a tumor diameter of >3 cm is an unfavorable prognostic factor. It does not depend on the number of positive lymph nodes. This suggests that we should be fully designing and analyzing clinical trials to determine patient treatment