Efficacy of chemotherapy for lymph node-positive luminal A subtype breast cancer patients: an updated meta-analysis

Objective To assess the association between chemotherapy and prognosis of patients with breast cancer of luminal A subtype and lymph node-positive, luminal A subtype breast cancer Methods Articles published between January 1, 2010, and May 1, 2020, were collected from PubMed, Embase, and Web of Science databases. On the basis of a test for heterogeneity, we selected the random effects model or fixed effects model for meta-analysis. Article quality was evaluated by sensitivity analysis, and Begg's and Egger's tests were used to measure publication bias. Results Six eligible articles were identified. The hazard ratio of overall survival of luminal A breast cancer patients who received both chemotherapy and endocrine therapy was 1.73 (95% CI 1.23, 2.43). The hazard ratio of overall survival for lymph node-positive, luminal A breast cancer patients who received chemotherapy and endocrine therapy was 1.86 and 95% CI 1.26, 2.81. The hazard ratio of relapse-free survival to disease-free survival was 1.30 (95% CI 0.85, 1.77). Tumor size, vascular invasion, and age did not show significant correlations with breast cancer prognosis. Conclusion Compared with endocrine therapy alone, the addition of chemotherapy did not improve the prognosis of patients with luminal type A and lymph node positive cancer; instead, side effects of the additional chemotherapy may have negatively affected prognosis. Prospective studies are needed to determine whether the number of positive lymph nodes also correlates with efficacy of chemotherapy of luminal type A breast cancer.