Analysis of Metastatic Involvement of Interpectoral (Rotter's) Lymph Nodes Related to Tumor Location, Size, Grade and Hormone Receptor Status in Breast Cancer

Aims and background This study was aimed at analyzing metastatic involvement in interpectoral (Rotter's) lymph nodes in relation to tumor location, size, grade and hormone receptor status in primary breast cancer. Methods The study included 172 female patients undergoing surgery for breast cancer at the University Hospital for Tumors, Zagreb, Croatia from November 2001 to August 2003. In addition to the standard surgical procedure, interpectoral (Rotter's) lymph nodes were removed in all of the patients. Serum levels of the tumor marker CA 15-3 were determined before surgery and hormone receptor status after surgery. Results Rotter's lymph nodes were identified in 67% of the patients, with metastatic involvement being found in 20% of the Rotter's nodes. Metastatic involvement of Rotter's nodes in patients with negative and positive axillary lymph nodes was 4% and 35%, respectively. When we looked at the location of the tumor in patients with metastatic involvement of Rotter's nodes, we found that tumors located in the upper quadrants were more prone to metastasis to Rotter's nodes; there was a significant positive correlation between tumor location and positive Rotter's nodes (r = 0.953, P = 0.012). As regards tumor size, Rotter's nodes were identified in 15%, 20% and 30% of stage T1 (<2 cm), T2 (2-5 cm) and T3 (>5 cm) tumors, respectively. Hormone receptor status showed no statistically significant difference in the expression of estrogen and progesterone receptors between patients with and those without positive Rotter's nodes. Of 35 Rotter's node-positive patients, 31.4% had elevated serum levels of CA 15-3; the level was significantly higher in Rotter's-positive patients compared to those with negative (or absent) Rotter's nodes. Conclusions The results show that one-fifth of breast cancer patients, or even one-third of those with positive axillary lymph nodes, are discharged with positive interpectoral lymph nodes that remain undiagnosed. As the nodes can be surgically removed without additional mutilation, exploration of Rotter's lymph nodes should be introduced into routine clinical practice.

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Evaluation of Hormone Receptors Status in Breast Carcinoma

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v10i2.41160 ◽

2019 ◽

Vol 10 (2) ◽

pp. 70-73

Author(s):

Kazi Nishat Ara Begum ◽

Abdul Khaleque Akond ◽

Naila Huq ◽

Nazneen Naher Aymon ◽

Fahmida Huq

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Lymph Nodes ◽

Hormone Receptor ◽

Hormone Receptor Status ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Middle Aged ◽

Outer Quadrant ◽

Receptor Status

Background & objective: The importance of establishing hormone receptor status of tumors for the treatment of women with hormone receptor-positive breast cancer is often emphasized. It is critical to evaluate hormone receptor status when considering response to endocrine therapy. The present study was intended to evaluate the usefulness of hormone receptor status in breast carcinoma. Materials & Methods: The present study was conducted in the Department of Pathology, Dhaka Medical College, Dhaka over a period 12 months from July 2009 to June 2010. A total of 30 histopathologically diagnosed cases of breast tumors who were also subjected to immunohistochemical (IHC) test for ER, PR status and HER-2/neu were consecutively included in the study. Patients who have already been treated for malignancy or who had a history of receiving radiotherapy were excluded. Result: Age distributions shows that 40% of the patients were early middle-aged (30-40 years), 30% middle-aged and the rest were either < 30 years or >50 years old. Left breast was involved more often (56.7%) than the right breast (43.3%). The predominant location was upper outer quadrant (43.3%), followed by upper inner quadrant (20%), lower outer quadrant (20%), lower inner quadrant (10%) and central (6.7%). Over half (53.3%) of the tumors were < 5 cm and the rest 5 cm or more. Nearly half (46.7%) of the tumors were moderately differentiated, 36.6% well-differentiated and 16.7% poorly differentiated. In majority (83.3%) of the cases lymph-nodes (axillary lymph nodes) were involved. Based on estrogen and progesterone receptor status, over half (53.3%) of the tumors were ER and PR positive and 40% were Her2/neu overexpressed. Conclusion: The study concluded that half of the Bangladeshi breast cancer patients are ER and PR positive and two in every five cases are Her2/neu overexpressed. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 70-73

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Assessing the impact of CMF-like/Anthracycline-based/Anthracycline-Taxane-based/dose-dense chemotherapy in dependency of positive axillary lymph nodes/hormone receptor-status/grading/T-stage on survival – A retrospective multi-centre cohort study of 3677 patients receiving adjuvant chemotherapy

European Journal of Cancer ◽

10.1016/j.ejca.2014.08.015 ◽

2014 ◽

Vol 50 (17) ◽

pp. 2905-2915 ◽

Cited By ~ 4

Author(s):

L. Schwentner ◽

A. Wöckel ◽

J. König ◽

W. Janni ◽

M. Blettner ◽

...

Keyword(s):

Cohort Study ◽

Adjuvant Chemotherapy ◽

Lymph Nodes ◽

Hormone Receptor ◽

Hormone Receptor Status ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Receptor Status ◽

Dose Dense ◽

The Impact

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Assessment of the receptor status in primary breast cancer with synchronous loco regional metastases: prognostic and clinical role?

Siberian Journal of Oncology ◽

10.21294/1814-4861-2019-18-2-78-82 ◽

2019 ◽

Vol 18 (2) ◽

pp. 78-82

Author(s):

O. O. Gordeeva ◽

L. G. Zhukova ◽

I. V. Kolyadina ◽

I. P. Ganshina

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Hormone Receptor ◽

Primary Breast Cancer ◽

Locally Advanced ◽

Metastatic Breast ◽

Hormone Receptor Status ◽

Primary Tumors ◽

Receptor Status ◽

Regional Metastases

Background. Assessment of hormone receptor status plays a crucial role in treatment of patients with breast cancer. currently, clinicians are limited to determining the expression status of estrogen receptor (ER), progesterone receptor (pR) and HER2 only in primary breast cancer tissues, even in the presence of regional metastases.The purpose of the study was to review available data on heterogeneity of ER, pR and HER2/neu expressions in primary breast cancer and regional metastases.Material and methods. We analyzed publications available from pubmed, medline etc. using the keywords «discordance», «breast cancer», «locally advanced», «regional lymph nodes», «ER», «pR», and «HER2».Results. The clinical and prognostic role in assessing the heterogeneity of the receptor status of primary tumors and synchronous regional metastases, as well as the effect of detected discordance on treatment tactics was assessed.Conclusion. Data on the frequency of discordance in hormone receptor status between primary and metastatic breast cancer tumors and its effect on the further prognosis in breast cancer are still contradictory. However, the fact of the presence of such heterogeneity suggests that some patients with affected lymph nodes will have significant benefits from determining the status of steroid hormones and HER2 not only in the primary tumor, but also in the lymph nodes, since it will open up new opportunities for subsequent targeted therapy.

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Relation of serum levels of estrogen and dehydroepiandrosterone sulfate to hormone receptor status among postmenopausal women with breast cancer

Breast Cancer ◽

10.2325/jbcs.14.269 ◽

2007 ◽

Vol 14 (3) ◽

pp. 269-276 ◽

Cited By ~ 12

Author(s):

Yoichiro Kakugawa ◽

Yuko Minami ◽

Hiroo Tateno ◽

Hiroko Inoue ◽

Tsuneaki Fujiya

Keyword(s):

Breast Cancer ◽

Postmenopausal Women ◽

Hormone Receptor ◽

Serum Levels ◽

Dehydroepiandrosterone Sulfate ◽

Hormone Receptor Status ◽

Receptor Status

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Quantitative Ultrasound Image Analysis of Axillary Lymph Nodes to Diagnose Metastatic Involvement in Breast Cancer

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2019.07.413 ◽

2019 ◽

Vol 45 (11) ◽

pp. 2932-2941 ◽

Cited By ~ 1

Author(s):

David Coronado-Gutiérrez ◽

Gorane Santamaría ◽

Sergi Ganau ◽

Xavier Bargalló ◽

Stefania Orlando ◽

...

Keyword(s):

Breast Cancer ◽

Image Analysis ◽

Lymph Nodes ◽

Quantitative Ultrasound ◽

Ultrasound Image ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Metastatic Involvement

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Accuracy of computed tomography perfusion in assessing metastatic involvement of enlarged axillary lymph nodes in patients with breast cancer

Breast Cancer Research ◽

10.1186/bcr1738 ◽

2007 ◽

Vol 9 (4) ◽

Cited By ~ 16

Author(s):

Yun Liu ◽

Massimo Bellomi ◽

Giovanna Gatti ◽

Xuejun Ping

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Lymph Nodes ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Computed Tomography Perfusion ◽

Metastatic Involvement

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Prognostic significance of cathepsins B and L in primary human breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1998.16.3.1013 ◽

1998 ◽

Vol 16 (3) ◽

pp. 1013-1021 ◽

Cited By ~ 103

Author(s):

J A Foekens ◽

J Kos ◽

H A Peters ◽

M Krasovec ◽

M P Look ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Lymph Nodes ◽

Hormone Receptor ◽

Steroid Hormone ◽

Menopausal Status ◽

Hormone Receptor Status ◽

Steroid Hormone Receptor ◽

Receptor Status ◽

Positive Lymph Nodes

PURPOSE Evaluation of the clinical significance of cytosolic tumor levels of the lysosomal cysteine proteases cathepsin B (catB) and cathepsin L (catL) in patients with primary breast cancer. PATIENTS AND METHODS CatB (n = 1,500) and catL (n = 1,391) levels were determined by enzyme-linked immunosorbent assay (ELISA) in cytosols routinely prepared from frozen-tissue samples that were submitted to our laboratory for the assessment of steroid-hormone-receptor status. The median duration of follow-up of patients still alive at the time of analysis was 93 months. RESULTS Relating catB and catL levels with classical prognostic factors, the proteases were positively correlated with the number of positive lymph nodes (P < .01), and negatively with the level of steroid-hormone receptors (P < .01). We did not find a significant relationship between catB or catL levels with age and menopausal status of the patients or with the size of the primary tumor. The levels of catB and catL were positively correlated with each other and with the rates of relapse and death (all, P < .0001). In multivariate regression analysis for relapse-free survival (RFS) and overall survival (OS), corrected for the contribution of age/menopausal status, tumor size, the number of positive lymph nodes, and steroid-hormone-receptor status, catB and catL were significant predictors of the rates of relapse and death (all, P < .01). No statistically significant interactions of catB or catL with any of the classical prognostic factors or with each other were observed in their associations with the rates of relapse and death. CONCLUSION CatB and catL levels measured in routinely prepared cytosols are strong parameters to predict the rate of relapse and the length of survival after treatment of the primary breast tumor.

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Localization of the Sentinel Lymph Node in Breast Cancer by Combined Lymphoscintigraphy, Blue DYE and Intraoperative Gamma Probe

Tumori Journal ◽

10.1177/030089160008600408 ◽

2000 ◽

Vol 86 (4) ◽

pp. 297-299 ◽

Cited By ~ 8

Author(s):

Giuseppe Villa ◽

Marco Gipponi ◽

Ferdinando Buffoni ◽

Carlo Vecchio ◽

Pietro Bianchi ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Predictive Value ◽

Gamma Probe ◽

Axillary Lymph Nodes ◽

Blue Dye ◽

Axillary Lymph ◽

Patent Blue ◽

Metastatic Involvement

Axillary lymph node status represents the most important prognostic factor in patients with operable breast cancer. A severe limitation of this technique is the relatively high rate of false negative sentinel lymph nodes (>5%). We studied 284 patients suffering from breast cancer; 264 had T1 tumors (16 T1a, 37 T1b and 211 T1c), while 20 had T2 tumors. All patients underwent lymphoscintigraphy 18-h before surgery. At surgery, 0.5 mL of patent blue violet was injected subdermally, and the sentinel lymph node (SN) was searched by gamma probe and by the dye method. The surgically isolated SN was processed for intraoperative and delayed examinations. The SN was successfully identified by the combined radioisotopic procedure and patent blue dye technique in 278/284 cases (97.9%). Analysis of the predictive value of the SN in relation to the status of the axillary lymph nodes was limited to 191 patients undergoing standard axillary dissection irrespective of the SN status. Overall, 63/191 (33%) identified SNs were metastatic, the SN alone being involved in 37/63 (58.7%) patients; a positive axillary status with negative SN was found in 10/73 (13.7%) patients with metastatic involvement. In T1a-T1b patients the SN turned out to be metastatic in 9/53 patients (17.0%). In 7/9 patients the SN was the only site of metastasis, while in 2/9 patients other axillary lymph nodes were found to be metastatic in addition to the SN. None of the 44 patients in whom the SN proved to be non-metastatic showed any metastatic involvement of other axillary lymph nodes. Our results demonstrate a good predictive value of SN biopsy in patients with breast cancer; the predictive value was excellent in those subjects with nodules smaller than 1 cm.

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