Correlation between extranodal invasion in axillary lymph node metastasis and prognosis of breast cancer patients
10.3760/cma.j.issn.0529-5807.2017.08.002
- VernacularTitle: 腋窝淋巴结结外侵犯与乳腺癌患者预后的关系
- Author:
Lingling ZHANG
1
;
Li MA
;
Cuizhi GENG
;
Ying JIA
;
Xiaoling WANG
;
Yueping LIU
Author Information
1. Department of Pathology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
- Publication Type:Journal Article
- Keywords:
Breast neoplasms;
Lymphatic metastasis;
Prognosis
- From:
Chinese Journal of Pathology
2017;46(8):525-529
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the significance of extranodal extension of axillary lymph nodes (ALN-ENE) metastases in post-operative primary invasive breast carcinoma of non-specific type.
Methods:Six hundred and thirty-eight invasive breast cancer cases confirmed by postoperative pathological examination were collected from January 2006 to December 2008. The relationship of lymph node metastases and ALN-ENE with other lymph node parameters and patient outcome was analyzed.
Results:Among 638 cases, 263 (41.2%) showed axillary lymph node metastases. ALN-ENE was present in 91 cases (36.4%). The rate of ALN-ENE increased with pT stage and tumor size. Five-year recurrence-free survival rate (RFS) and 5-year overall survival rate (OS) was 86.6% and 91.2% respectively for ALN-ENE positive group, and both were lower than ALN-ENE negative group (P<0.01). One hundred and forty-nine patients with 1 to 3 positive lymph nodes had a 5-year RFS of 91.9%, and 5-year OS of 92.3%, less than ALN-ENE negative group (P<0.01). Univariate analysis showed ALN-ENE positively correlated with lymph node metastasis. Multivariate analysis suggested that ENE was associated with increased recurrence risk and shortened recurrence-free and overall survival, especially in patients with 1 to 3 positive lymph nodes; and it was an independent prognostic factor (P<0.01).
Conclusions:The number of lymph nodes metastases is an important predictor of survival in breast cancer patients. ALN-ENE is an independent risk indicator for recurrence and overall survival. For patients with 1 to 3 metastatic axillary lymph nodes, ALN-ENE could alter the patient′s clinical pathologic staging, and therefore it is an independent prognostic factor.
