Is Tumour Size an Independent Predictor for Axillary Lymph Node Metastasis in Infiltrating Duct Carcinoma Breast in T2 and T3 Tumours : Prospective Review of 256 Cases

Abstract

Background: As breast cancer remains a major fraction of cancer cases worldwide, the options for minimalizing postoperative morbidity and mortality remain an area for ardent research and improvement. The ability to identify patients at low risk of axillary metastases, would be of great value in limiting extensive axillary dissection which causes signicant morbidity, thereby improving the postoperative quality of life amongst patients. We conducted a study to identify characteristics of primary tumors highly associated with axillary lymph node metastases by comparing various demographic and tumor characteristics against nodal status. Methodology: 288 cases of the axillary dissection specimens of all inltrating duct carcinoma cases who underwent MRM in Government Medical College, Thrissur for 5 consecutive years were studied (n=256). Pathology was interpreted by a select group of Pathologists and then reanalyzed by another set to avoid bias. Various other aspects were studied including age distribution, histology, tumour size and nodal status. Analysis was done using SPSS 26 software. Results: The mean age of the study population was 50.58 years. The most common histopathological type encountered was Invasive ductal carcinoma – NOS (89.58%). Most of the patients (78.29%) belonged to T2 stage, with most patients (76.39%) having 1- 3 nodes involved. On analysis, a signicant association between T status ( T2 ,T3 ) and N status (p = 0.001) was found. However, there was no signicant correlation between age against tumor size or nodal status (p = 0.528, and p = 0.614 respectively). Conclusions: This study found that while tumor size is independently can predict the amount of axillary lymph node metastasis especially in T2 and T3 tumors , there is no signicant predictor value for age in predicting the nodal status or tumor size in invasive ductal carcinoma. However, the factors which modifying tumor behavior like the grade, ER status, Her2 neu status and Cerb 2 will have an inuence on the prediction of Axillary Lymph node involvement that offers further scope of prospective research