الفهرس 
Acknowledgement.Only 14 pages are availabe for public view
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Abstract
Breast cancer is the most frequent malignant tumor in women worldwide. The incidence and mortality rates among females vary among countries but are steadily increasing worldwide. The importance of detecting proper factors as a protectors and determinants for the overall survival for mastectomy patients is as equal as the importance of the mastectomy itself as this will affect the methods of follow-up, adjuvant therapy and the patients` lifestyle.
There are several addressed prognostic factors for breast cancer cases that affect the overall survival including patient related, tumor related, histopathological and hormonal factors. However, at the dawn of the molecular era, the status of the axillary lymph nodes (ALN) remains the single most important determinant of overall survival in breast cancer. Knowledge of this status is gained through pathologic examination of the ALN retrieved by full ALN dissection (ALND).
Although the number of ALN involved with cancer has been demonstrated to be important for prognosis, the role of the total number of ALN retrieved in an ALND specimen has received less emphasis.This is despite data that clearly suggest that the likelihood of finding positive nodes in the axilla increases with the number of nodes dissected, and the likelihood of having residual disease in the axilla decreases with a more extensive dissection.In an attempt to address the above, several studies have focused on the utility of the axillary lymph node ratio (ALNR) as an independent prognostic indicator of overall survival.
The present study was conducted aiming to assess the impact of lymph node density in non-metastatic breast cancer. To fulfill the aim of the study a sample of 135 females with breast cancer were selected randomly; they were subjected to modified radical mastectomy followed by assessment and analysis of the excised lymph nodes and correlating their pathological characteristics with several personal, pathological and prognostic data.
During analyzing the data of the cases, many correlations were assessed particularly important are the relations between the prognostic factors and the axillary lymph node ratio with the overall survival, the present study demonstrates a statistically significant negative correlation between ALNR and the overall survival, thus supporting the aim and objectives of the study. On the other hand, the other correlations with other prognostic factors were not statistically significant. The present study concluded that the ALNR is a stronger factor in predicting overall survival than the absolute number of positive ALNs and the other prognostic factors. It may aid in subdividing patients with positive ALNs into low-risk and high-risk groups, with potential implications for their subsequent adjuvant treatment.