The Predictor of Axillary Lymph Node Metastases in Breast Cancer.
- Author:
Gyu Seok CHO
1
;
Chul Wan LIM
;
Nae Kyung PARK
;
Sung Pil JEUNG
;
Kyung Kyu PARK
;
Kyung Yul HUR
;
Yong Seok JANG
;
Jae Eog AHN
;
Jai Soung PARK
;
Hae Kyung LEE
;
Min Hyuk LEE
Author Information
1. Department of Surgery, Soonchunhyang University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Breast cancer;
Axillary lymph node metastases
- MeSH:
Breast Neoplasms*;
Breast*;
Carcinoma, Intraductal, Noninfiltrating;
Cathepsins;
Drainage;
Estrogens;
Female;
Humans;
Incidence;
Lymph Node Excision;
Lymph Nodes*;
Lymphedema;
Menstruation;
Multivariate Analysis;
Neoplasm Metastasis*;
Prognosis;
Upper Extremity
- From:Journal of the Korean Surgical Society
1999;57(6):806-813
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The presence of axillary lymph node metastases (ALNM) and tumor size are two most important prognostic factors in breast cancer. An axillary lymph node dissection (ALND) is usually performed in infiltrating breast cancer for the information of therapeutic decision and prediction of prognosis. However this procedure results in lymphedema of the affected upper extremity, increased axillary drainage, sensory abnormality, and pain. If the axillary lymph node status could be predicted accurately prior to an ALND, selected patients with a low probability of ALNM could be spared the procedure. The purpose of this study was to determine the association between the incidence of ALNM and 14 clinico-pathologic factors by using univariate and multivariate analysis and to investigate the possibility of using those factors as predictors for ALNM. METHODS: We reviewed data from 253 patients with breast cancer who had undergone at least a level I/II axillary dissection between 1991 and 1998. The association between the incidence of ALNM and 14 clinico-pathologic factors (age, menstruation, tumor size, palpability of tumor, tumor site, pathologic type, nuclear grade, estrogen receptor status, progesteron receptor status, p53, c-erbB-2, Ki67, Cd34, and Cathepsin D) were analyzed by using univariate and, when significant, multivariate analysis. RESULTS: Approximately 38.7% of the 253 patients with breast cancer had ALNM. Univariate analysis showed that ALNM were associated with tumor size (P<0.01), pathologic type (P<0.001), palpability (P<0.01), and nuclear grade (P<0.01). However, independent predictors of ALNM in the multivariate analysis were tumor size and pathologic type. Among the patients with smaller than 1.0 cm in the tumor size and DCIS in the pathologic type, the ALNM was not founded. CONCLUSIONS: We conclude that the characteristics of primary breast cancer can help assess the risk for ALNM. Selected patients, who are assessed to be minimal risk, might be spared a routine ALND, if the treatment decision would not be influenced by the lymph node status.
