Patterns of Axillary Lymph Node Metastasis in Breast Cancer: A Prospective Single-Center Study.
- Author:
Hee Jun CHOI
1
,
2
;
Jae Myung KIM
;
Jai Min RYU
;
Isaac KIM
;
Seok Jin NAM
;
Jonghan YU
;
Se Kyung LEE
;
Jeong Eon LEE
;
Seok Won KIM
Author Information
- Publication Type:Original Article
- Keywords: Axilla; Breast neoplasms; Lymphatic metastasis
- MeSH: Axilla; Breast Neoplasms*; Breast*; Drug Therapy; Humans; Indocyanine Green; Lymph Nodes*; Lymphatic Metastasis; Multivariate Analysis; Neoplasm Metastasis*; Optical Imaging; Prospective Studies*; Risk Factors
- From:Journal of Breast Cancer 2018;21(4):447-452
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The recent trend in breast cancer treatment is to minimize axillary dissection. However, no pattern of axillary metastasis has been precisely established. The purpose of this study was to evaluate the metastatic lymphatic pattern using near-infrared fluorescence imaging with indocyanine green (ICG) in breast cancer with cytologically proven axillary metastasis. METHODS: This was a prospective single-center study. We evaluated 147 patients with breast cancer involving cytologically proven axillary metastasis, and compared physiological and nonphysiological lymphatic metastasis. RESULTS: We performed lymphatic mapping for 64 patients who exhibited level II lymphatic flow on near-infrared fluorescence imaging with ICG, and found that all had axillary metastasis: 51 patients who did not receive neoadjuvant chemotherapy (NAC) and 13 patients post-NAC. Of patients who did not receive NAC, 32 had physiological lymphatic metastasis and 19 had nonphysiological lymphatic metastasis. The risk factors for nonphysiological lymphatic metastasis were age ≥55 years, high Ki-67 index (>20%), and perinodal extension in both univariate and multivariate analysis (p < 0.05). CONCLUSION: Patients with identified risk factors in cytologically-proven axillary metastasis who did not receive NAC may have nonphysiological lymphatic metastasis.
