Prediction of lymph node metastasis by tumor-infiltrating lymphocytes in T1 breast cancer

Abstract

Background: Lymph node metastasis is more likely in early-stage breast cancer with lower tumor-infiltrating lymphocyte (TIL) density. Therefore, we investigated the correlation between TILs and lymph node metastasis in cT1 breast cancer patients undergoing surgery and the usefulness of TILs in predicting sentinel lymph node metastasis (SLNM) in cT1N0M0 breast cancer. Methods: We investigated 332 breast cancer patients who underwent surgery as the first-line treatment after preoperative diagnosis of cT1. A positive diagnosis of SLNM as an indication for axillary clearance was defined as macrometastasis in the sentinel lymph node (SLN) (macrometastasis: tumor diameter > 2 mm). Semi-quantitative evaluation of lymphocytes infiltrating the peritumoral stroma as TILs in primary tumor biopsy specimens prior to treatment was conducted. Results: For SLN biopsy (SLNB), a median of 2 (range, 1-8) SLNs were pathologically evaluated. Sixty cases (19.4%) of SLNM (macrometastasis: 46, micrometastasis: 16) were observed. Metastasis was significantly greater in breast cancers with tumor diameter > 10 mm than in those with diameter ≤ 10 mm (p = 0.016). Metastasis was significantly associated with lymphatic invasion (p < 0.001). These two clinicopathological factors correlated with SLNM even in patients diagnosed with cN0 (tumor size; p = 0.017, lymphatic invasion; p = 0.002). Multivariate analysis for SLNM predictors revealed lymphatic invasion (p = 0.008, odds ratio [OR] = 2.522) and TILs (p < 0.001, OR = 0.137) as independent factors. Conclusions: Our results suggest a correlation between lymph node metastasis and tumor immune-microenvironment in cT1 breast cancer. TIL density may be a predictor of SLNM in breast cancer without lymph node metastasis on preoperative imaging.

Prediction of Distant Metastatic Recurrence by Tumor-Infiltrating Lymphocytes in Hormone Receptor-Positive Breast Cancer

“…In this study, TILs were suggested to possibly be a distant metastatic predictor, although not an independent factor. We have reported that TILs may also be involved in lymph node metastasis in HR + HER2 − BC [51]. In this study, TILs were considered to be strongly correlated with lymph node metastasis, being involved in distant metastasis prediction as well as prognosis after recurrence.…”

Prediction of distant metastatic recurrence by tumor-infiltrating lymphocytes in hormone receptor-positive breast cancer

“…In this study, TIL density was suggested to possibly be a distant metastatic predictor, although not an independent factor. We previously reported that TILs may also be involved in lymph node metastasis in HR+/HER2-breast cancer [52]. In this study, TILs were considered to be strongly correlated with lymph node metastasis, and were involved in distant metastasis prediction as well as prognosis after recurrence.…”

The expression and prognostic value of the epidermal growth factor receptor family in glioma

“…An increasing number of studies have shown that tumor-infiltrating lymphocytes can be used as related indicators to predict tumor metastasis and invasion [ 36 , 37 ]. Therefore, by analyzing the TIMER database, we found a correlation between the expression levels of the members of the EGFR family and the level of immune infiltration in glioma tissues.…”