Primary tumour characteristics and axillary lymph node status in breast cancer

Abstract

Summary This paper examines the correlation between axillary lymph node status and primary tumour characteristics in breast cancer and whether this can be used to select patients for axillary lymphadenectomy. The results are based on a retrospective analysis of 909 patients who underwent axillary dissection in our unit. Axillary lymph nodes containing metastases were found in 406 patients (44.7%), all with invasive carcinomas, but in none of the 37 carcinomas-in-situ. Nodal status was negative in all T1a tumours, but lymph node metastases were present in 16.3% and 35.7% of T1b and T1c tumours respectively. When histological grade was taken into account, positivity for grade I T1b and T1c tumours fell to 13.6% and 26.7% respectively. Lymph node metastases were found in 85% of patients with lymphovascular invasion in their tumours as compared to only 15.4% of those without and in 45.5% of oestrogen and progesterone receptor-positive tumours. When one or both hormone receptors were absent this figure was much higher. It appears that for T1a breast cancers axillary dissection is not necessary, whereas for T1b, T1c and grade I T2 tumours other histopathological parameters should be taken into consideration in deciding who should undergo axillary lymphadenectomy.

Predictors of Axillary Lymph Node Status in Early Breast Cancer: A Single Center Analysis of 81 patients at a Tertiary Care Hospital in North-East India

“…Larger tumor size was found to be an independent predictor of node positive disease in our study, concurring with the data from several other centres [24][25][26] . Previous studies also suggest a significant relationship between tumor size and recurrence free survival.…”

Breast conservation, mastectomy and axillary surgery in New South Wales women in 1992 and 1995

“…The patterns of axillary surgery mirrored US experience, accompanying mastectomy more often than BCT and being inversely related to women's ages and only weakly related to cancer size (Du et al, 1999;Nattinger et al, 2000). Since larger cancer size predicts positive nodes and young women have a higher probability of positive nodes than women of other ages (Olivotto et al, 1998;Yiangou et al, 1999), axillary surgery appeared to be appropriately targeted to younger women but less evidently to larger breast cancers.…”

Significance of lymph vessel invasion identified by the endothelial lymphatic marker D2-40 in node negative breast cancer

“…[2][3][4][5][6][7][8][9] LVI has also been shown to be a predictor of axillary lymph node metastasis. 7,[10][11][12][13] It has been proposed that LVI could be used to identify a subgroup of axillary node-negative patients with an unfavorable prognosis that are likely to benefit from adjuvant chemotherapy. [6][7][8] Furthermore the presence of peritumoral LVI, as assessed on haematoxylin and eosin-(H&E) stained slides, has recently been added to the St Gallen criteria for the selection of adjuvant systemic therapy in operable breast cancer.…”