Factors correlating with lymph node metastases in patients with T1 ductal invasive breast cancer

Abstract

BACKGROUND: Identification of reliable predictors of axillary lymph node metastases (ALNM) may be useful in selecting appropriate management for patients with T1-size breast cancer. This study was undertaken to determine the association between ALNM and several variables, including age, tumor size, grade, estrogen receptor status, progesterone receptor status, p53 and c-erbB2 protein expression, and Ki-67 proliferative index. METHODS: In a retrospective study, 74 patients with pT1b and pT1c ductal invasive breast carcinoma and with known nodal status were analyzed. The size of the infiltrating tumor was microscopically evaluated. The histological grading was performed using the modified criteria of Bloom and Richardson, as described by Elston and Ellis. The immunophenotype of the tumor was determined as: the expression of estrogen (ER) and progesterone (PR) receptors, p53, c-erbB2 and Ki-67. The patients were grouped by age as follows: <50, 50-70, and >70 years old. RESULTS: Twenty six patients (35%) were node positive. Tumor size was related directly to nodal positivity. Nodal positivity was significantly related to negative PR status, p53 protein overexpression and high Ki-67 index (p<0.05). No significant association was found between nodal positivity and patient age, tumor grade, ER status, and c-erbB2 expression. CONCLUSION: These data suggest that PR status, Ki-67 proliferation index, and p53 protein expression might provide additional information to the lymph node status in T1 ductal breast carcinomas

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

“…This age distribution of our patients was lower than that seen in western and Arab countries1012. No significant association was observed between different ages at breast cancer diagnosis and LNs metastases as reported earlier1113. But our data contradicted the result of Gajdos et al 14 who studied 850 consecutive patients with T1 breast cancer and Olivotto et al 15 from Canada who analysed 4312 women.…”

“…Previous studies have reported an association of lymph nodes with age in breast cancer patients1011. This age distribution of our patients was lower than that seen in western and Arab countries1012.…”

Sentinel lymph nodes with isolated tumour cells and micrometastases in breast cancer: clinical relevance and prognostic significance

“…The observed difference was not statistically significant (p=0.445) and these patients did not show any inferior survival (figure 7). These observations are in line with some published studies that additional ALND offers no added advantage in DFS and OS when compared with patients who received SLND alone20 28 and may support the conclusion of some investigators that patients with ITCs and micrometastases in the SLNs who undergo breast conserving treatment with radiotherapy to breast and low ALNs may not be adversely affected by not having completion ALND,32 33 36–39 and that any residual disease left in non-SLNs can be eliminated by chemotherapy 28…”

“…No disease recurrence or deaths were seen in patients with ITCs suggesting that the risks associated with ITCs are minimal, may not be of clinical significance and are not associated with a worse outcome,20 28 justifying their segregation from micrometastases for prognostic purposes 21…”

Factors Predicting the Axillary Lymph Node Metastasis in Breast Cancer: Is Axillary Node Clearance Indicated in Every Breast Cancer Patient?

“…There was no significant relationship between age and race and lymph node involvement [10]. Among patients affected with breast cancer, younger patients have a higher incidence of axillary nodal metastases than older patients [11].…”