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

Ashturkar, Amrut V; Pathak, Gayatri S; Deshmukh, Sanjay D; Pandave, Harshal T.

doi:10.1007/s12262-011-0315-5

Cited by 20 publications

(17 citation statements)

References 19 publications

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“…The present study found significant correlation between high-grade breast cancers and node positive patients akin to the studies mentioned above. Hence, grading of breast cancer can be recommended to be used as an independent prognostic as well as predictive assessment tool, the findings in our study were statistically significant and similar to the findings of Chakraborty A et al, 14 Amrut V. Ashturkar et al 15…”

Section: Present Study In Comparison With Other Studiessupporting

confidence: 90%

Utility of Nottingham’s Modification of Bloom-Richardson’s Grading as a Time Bound Predictive Prognostic Tool in Diagnosis of Breast Cancer

Shukla¹,

Acharya²,

Tamhane³

et al. 2017

jebmh

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BACKGROUNDThe breast cancer among women both in the developed and developing world is rampant, the assessment of grading system of carcinoma breast and its utility for better time-bound prognostification can significantly improve in predicting aggressive tendency of the breast cancer and also further help develop a therapeutic protocol.The aim of the study is to compare between the histopathological tumour grade with prognostic factors like age (based on menstrual status), tumour size, lymph node status and to establish histopathological grading (modified Bloom-Richardson's) as a time-bound prognostic indicator. MATERIALS AND METHODSThe present work was carried out in the histopathology and immunohistochemistry section of Department of Pathology, Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi (M), Wardha, from January 2013 to July 2016. It was a prospective analytical study. A tota1 of 114 female patients presenting in the Outpatient Department of Surgery with lump in breast were included in the present study. All patients underwent modified radical mastectomy for tumour resection. Tumour masses and lymph nodes were subjected to routine H and E staining, then examined by senior pathologist. Comparisons were made between histopathology grades with patient age, tumour size and lymph node status. RESULTSThe study found that the breast carcinoma having an excellent correlation between the histopathologic grades and the wellestablished prognostic tools, i.e. tumour size, lymph node status, though age-based on menstrual status was insignificant statistically. The 'p' value was significant when correlation between histopathological grade, tumour size and lymph node status was done respectively, P=0.0001, S; P=0.0006, S, whereas the 'p' value was insignificant, i.e. P=0.18, NS when correlation between the histopathology grade and age was done. CONCLUSIONNottingham's modification of Bloom-Richardson histopathological grade being an excellent predictive prognostic tool should be continued for assessing the grades in breast cancer patients as well as be incorporated at the clinical level with the tumour size, nodal involvement, metastasis (TNM) staging of breast cancers.

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Section: Present Study In Comparison With Other Studiessupporting

confidence: 90%

Utility of Nottingham’s Modification of Bloom-Richardson’s Grading as a Time Bound Predictive Prognostic Tool in Diagnosis of Breast Cancer

Shukla¹,

Acharya²,

Tamhane³

et al. 2017

jebmh

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“…6 In this study 742 patients had axillary lymph node metastasis. 8 In study by Gurleyik et al tumour size was not found to be an important factor for axillary involvement. Axillary metastasis was significantly associated with LVI (p<0.001).…”

Section: Review Of Literature Factors Affecting Involvement Of Axillamentioning

confidence: 87%

Changing Trends in Axillary Management of Early Breast Cancer: From Radical to Conservative

Sood¹,

Singh²,

Sharma³

2016

IJMRP

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Background:In the last decade, surgical management of breast cancer has evolved from more extensive procedures like radical mastectomy to less invasive breast conserving surgery. Increasing evidence suggests that surgical removal of the axillary lymph nodes (ALN) in early breast cancer yields no advantage in terms of either overall or disease free survival. Significance of sentinel lymph node biopsy (SLNB) in neoadjuvant chemotherapy (NACT) is currently under discussion. A risk of non -sentinel lymph node ( non-SLN) involvement is always present despite negative SLN biopsy . There are various tumour characteristics and patients' factors that are associated with increased risk of non-SLN involvement. Methods: A literature search was performed in the PubMed Database for relevant articles on the role of axillary dissection in node positive early breast cancer, the role of SLNB, SLNB after NACT and the factors affecting involvement of axillary lymph nodes Results: The available literature increasingly cast doubt on the putative therapeutic benefit of axillary lymph node dissection (ALND) as a part of routine multimodal treatment strategy for breast cancer. Various clinicopathological features like lymphovascular invasion (LVI), tumour size, ER, PR, HER-2 status are associated with increased incidence of non -SLN involvement so ALND should be limited to patients with these characteristics inspite of negative SLNB. Conclusion: Current evidence indicates that the radicality of lymph node surgery in the treatment of breast cancer can be reduced, even if the node status is positive.LVI, increased tumour size , Infiltrating ductal carcinoma(IDC), Grade II&III and ER , PR, HER-2 overexpression significantly associated with positive axillary status .

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“…However, our study failed to show a significant relationship between combined ER & PR receptor status and LN involvement. However, a study by Ashturkar et al (3) showed that negative ER and PR status was significantly associated with low risk of axillary node metastasis.…”

Section: Receptor Status and Ln Involvementmentioning

confidence: 98%

The Relationship between Clinico-Pathological Variables and Axillary Lymph Node Status in Breast Cancer in a Single Cancer Center in Jordan

Soudi¹,

Eboos²,

Al-Aish³

2015

JRMS

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Objective:To determine the relationship between axillary lymph node involvement and clinicopathological variables in a single cancer center in Jordan. Methods:This retrospective study was conducted in Al-Hussein Hospital in Amman from Jan 2011 till Jan 2013. This study revised the histopathology reports of 204 patients who all underwent modified radical mastectomy for invasive breast cancer. Various clinico-pathological factors of age, estrogen/progesterone receptor status, tumor size, histological type and grade were statistically correlated with lymph node involvement using contingency tables and P values.Results: Axillary lymph node involvement was noted in 152 (74.5%) with an average of five nodes involved (range 1-41). Mean age was 51.3 years. Around eighty percent of patients were above 40 years old and had involved lymph node whereas only twenty percent were below 40 years with involved lymph node. Average tumor size was 3.5cm with 67.1% between 2-5cm (T2). The most common tumor type and grade was invasive ductal carcinoma (NOS) (170 patients (83.3%)) and grade 2 (119 patient (58.3%)). The Majority of tumors were both ER and PR positive 75%. Tumor grade, size and histological type significantly correlated with lymph node involvement whereas age and receptor status had no significant correlation. Conclusion:The majority of patients in our centre present with node positive breast cancer. In a Jordanian population, as has been demonstrated in the world literature, there is a statistically significant relation between axillary lymph node involvement and tumor, size, grade and type and that age is not an independent predictor for node positivist.

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

Cited by 20 publications

References 19 publications

Utility of Nottingham’s Modification of Bloom-Richardson’s Grading as a Time Bound Predictive Prognostic Tool in Diagnosis of Breast Cancer

Utility of Nottingham’s Modification of Bloom-Richardson’s Grading as a Time Bound Predictive Prognostic Tool in Diagnosis of Breast Cancer

Changing Trends in Axillary Management of Early Breast Cancer: From Radical to Conservative

The Relationship between Clinico-Pathological Variables and Axillary Lymph Node Status in Breast Cancer in a Single Cancer Center in Jordan

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