Determinants of lymph node status in women with breast cancer: A hospital based study from eastern India

Chakraborty, Abhijit; Bose, Chinmoy K; Basak, Jayasri; Sen, A.N.; Mishra, Raghwendra; Mukhopadhyay, Ashis

doi:10.4103/0971-5916.191761

Cited by 8 publications

(5 citation statements)

References 24 publications

(26 reference statements)

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“…In agreement with various studies [23][24][25], there is increased incidence of axillary lymph node involvement and the frequency of positive axillary nodes also increased with increasing size of the tumor. Larger tumour size could be used as an independent predictor of node positive disease in our study, in agreement with data from Eastern India [26]. Large tumour size at presentation may be explained by the aggressive behaviour of these tumours and also due to the lack of health education and breast screening programmes for BC in Ethiopia.…”

Section: Discussionsupporting

confidence: 90%

Patterns of Breast Cancer Among Ethiopian Patients: Presentations and Histopathological Features

Gemta¹,

Bekele²,

Mekonen³

et al. 2019

J Cancer Sci Ther

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Background: Breast cancer is the most common malignancy in women and the leading cause of cancer deaths worldwide. In Ethiopia breast cancer is among the most prevalent cancer and occurs at young age. It usually presents at an advanced stage. Objective: To describe the frequency, stages, histological patterns, staging and grading of breast cancers among Ethiopian women in three Hospital in Addis Ababa, Ethiopia. Methods: A prospective study of 197 patients who presented to three hospital with breast cancer and underwent surgery from December 2013-December 2015. Tissue were fixed in 10% formalin solution and paraffin embedded. Hematoxylin and Eosin (H&E) stained slides were prepared in all cases and reviewed and classify according to the WHO. Results: The mean ± SD age of the participants was 44.77 ± 13.6 and the median was 42 years. Most patients were aged less than 50 years (70.6%) at the time of diagnosis. 57.4% were pre-menopausal and 42.6% were postmenopausal. The duration of symptom before presentation ranged from 2 to 48 months with mean ± SD 18.11 ± 13.2 months. Invasive ductal carcinoma was the commonest (79.2%) histologic type of breast cancer. Of all patients, (46.2 %) of patients had grade 2, while (36.5%) of the cases were grade 3 or poorly differentiated tumors. Most patients (70%) presented with advanced stage (III and IV) and more than (90 %) tumor were >2 cm in size. Conclusion: Our study shows breast cancer is a common disease that affects young Ethiopian women, and that there is a significant delay in presentation and advanced stage presentation is a major concern. It should be recognized that breast cancer is a disease with a serious public health implication.

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Section: Discussionsupporting

confidence: 90%

Patterns of Breast Cancer Among Ethiopian Patients: Presentations and Histopathological Features

Gemta¹,

Bekele²,

Mekonen³

et al. 2019

J Cancer Sci Ther

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“…In our study, the results show that women who had a larger tumor also had a larger number of axillary involved lymph nodes. This has also been consistently shown in various studies (23,32). Postacı et al (2013), reported a close relationship between tumor size and axillary lymph node involvement (33).…”

Section: Discussionsupporting

confidence: 71%

“…ER-positive patients were at higher risk of having a greater number of nodes than ER-negative patients and PRpositive are signi cantly increase the odds of have any number of axillary lymph nodes involvement in the early stages of breast cancer. This nding was con rmed in various studies (23,32).…”

Section: Discussionsupporting

confidence: 67%

“…Postacı et al (2013), reported a close relationship between tumor size and axillary lymph node involvement (33). The risk of axillary lymph node metastasis increases with increasing tumor size, suggesting that nodal metastasis is indicative of tumor chronology (32). A subtle assessment of hormone receptors in breast cancer has become necessary to select therapeutic agents according to recommendations and guidelines for postoperative adjuvant systemic therapy of early breast cancer.…”

Section: Discussionmentioning

confidence: 99%

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Robust Inference for Zero-Inflated Models with Outliers Applied to the Number of Involved Lymph Nodes in Patients with Breast Cancer

Shahsavari

Yaseri

Hosseini

et al. 2023

Preprint

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Objective: The aim of this study is to investigate the factors that influencing the number of axillary lymph nodes in women diagnosed with early breast cancer by choosing a strong model to evaluate the excess of zeros and outliers usually present in these data. Methods: The study based on a retrospective analysis of hospital records of 669 breast cancer patients in Iran. Zero-inflated, robust zero-inflated and Bayesian modelling techniques were used to assess the association between factors studied and the number of involved lymph nodes in breast cancer patients. Count data models, including zero-inflated models (zero-inflated Poisson and zero-inflated negative binomial), robust zero-inflated models (robust zero-inflated Poisson and robust zero-inflated negative binomial) and Bayesian models (Bayesian zero-inflated Poisson and Bayesian zero-inflated negative binomial) were applied. Performance evaluation of models was compared using AIC and BIC. Results: According to the AIC and BIC, the robust zero-inflated negative binomial model is the best model. Findings indicate that women who had a larger tumor had a greater number of axillary lymph nodes, hormone receptor status was associated with the number of lymph nodes, tumor grades II and III also contributed to a higher number of lymph nodes. Women who were older had a higher risk of having lymph nodes. Conclusions: Our analysis showed that the robust zero-inflated negative binomial is the best model for predicting and describing the number of nodes involved in primary breast cancer when overdispersion and outliers occurs.

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“…Several factors, including a higher ER-positivity rate, the prevalence of c-myc expression [ 24 ], as well as the elevated expression of osteopontin [ 25 ] and the ryanodine receptor 3 gene [ 26 ], were believed to contribute to the microcalcifications. Several factors, including HER2 positivity [ 23 ], the number of a CK19 mRNA copies [ 27 ], an elevated expression of osteopontin [ 25 ], T size and LVI [ 27 ], tumor grade [ 28 ], and clinical stage [ 28 ] were believed to contribute to lymph node metastases. However, questions regarding the most significant factor affecting lymph node metastases or the presence of microcalcifications remain unanswered.…”

Section: Discussionmentioning

confidence: 99%

BI-RADS 3-5 microcalcifications: prediction of lymph node metastasis of breast cancer

et al. 2017

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PurposeTo determine whether the clinicopathological parameters and Breast Imaging Reporting and Data System (BI-RADS) 3–5 microcalcifications differed between lymph node positive (LN (+)) and lymph node negative (LN (−)) invasive ductal carcinoma (IDC).ResultsFor microcalcification-associated breast cancers, seven selected features (age, tumor size, Ki-67 status, lymphovascular invasion, calcification range, calcification diameter and calcification density) were significantly associated with LN status (all P < 0.05). Multivariate logistic regression analysis found that three risk factors (age: older vs. younger OR: 0.973 P = 0.006, tumor size: larger vs. smaller OR: 1.671, P < 0.001 and calcification density: calcifications > 20/cm2 vs. calcifications ≤ 20/cm2 OR: 1.698, P < 0.001) were significant independent predictors. This model had an area under the receiver operating characteristic curve (AUC) of 0.701. The nodal staging (N0 and N1 χ2 = 5.701, P = 0.017; N0 and N2 χ2 = 6.614, P = 0.013) was significantly positively associated with calcification density. The luminal B subtype had the highest risk of LN metastasis. Multivariate analysis demonstrated that calcification > 2 cm in range (OR: 2.209) and larger tumor size (OR: 1.882) were independently predictive of LN metastasis in the luminal B subtype (AUC = 0.667).Materials and MethodsMammographic images of 419 female breast cancer patients were included. Associations between the risk factors and LN status were evaluated using a Chi-square test, ANOVA and binary logistic regression analysis.ConclusionsThis study found that age, tumor size and calcifications density can be conveniently used to facilitate the preoperative prediction of LN metastasis. The luminal B subtype has the highest risk of LN metastasis among the microcalcification-associated breast cancers.

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Determinants of lymph node status in women with breast cancer: A hospital based study from eastern India

Cited by 8 publications

References 24 publications

Patterns of Breast Cancer Among Ethiopian Patients: Presentations and Histopathological Features

Patterns of Breast Cancer Among Ethiopian Patients: Presentations and Histopathological Features

Robust Inference for Zero-Inflated Models with Outliers Applied to the Number of Involved Lymph Nodes in Patients with Breast Cancer

BI-RADS 3-5 microcalcifications: prediction of lymph node metastasis of breast cancer

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