A patient is diagnosed with carcinoma of the breast. The most important prognostic factor in the treatment of this disease is

Correct Answer: Axillary metastases
Description: Recognition of the high risk associated with axillary metastases for early death and poor 5-year survival has led to the use of postsurgical adjuvant chemotherapy in these patients. Patients who have estrogen- or progesterone-receptive tumors (i.e., receptor present or receptor-positive) are particular candidates for this adjuvant therapy, as 60% of estrogen-positive tumors will respond to hormonal therapy. Age and size of the tumor are certainly factors of importance, but they are secondary to the presence or absence of axillary metastases.
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