Quantifying the number of lymph nodes for examination in breast cancer

Abstract

Objective Examining the correct number of lymph nodes when diagnosing breast cancer invasion is still a problem. This work aimed to develop a qualification model that estimates the possibility of missing nodes and the number of lymph nodes that need to be examined. Methods By analyzing lymph node invasion of 303,760 breast cancer samples with primary tumor stage and the number of examined and positive lymph nodes from the Surveillance, Epidemiology and End Results database using a beta-binomial model, the number of nodes that should be examined was quantified in different stages. Results In general, to reduce the possibility of missing positive nodes to less than 10%, 21 lymph nodes should be examined; thus, the current median of dissected nodes (12) is not adequate. The number of nodes needed to be dissected for stages T1, T2, and T3 are 8, 37, and 87, respectively. Currently, the median number of node dissections for these stages were 12, 13, and 14, respectively. The clinical significance of the nodal staging score was validated with survival information. Conclusion Currently, the number of lymph nodes dissected in breast cancer are excessive for T1 but insufficient for T2 and T3.

Risk factors for central lymph node metastasis in papillary thyroid microcarcinoma – a retrospective study of 1433 cases from a single center

“…However, the reasons for the heterogeneity in lymph node sampling may include the surgical competence and/or pathologist related variables. But in a variety of tumors, quantification of lymph nodes has been studied extensively [37][38][39]. However, few recommendations [40] have been made for the number of lymph nodes in the thyroid.…”