Independent risk factors for axillary lymph node metastasis in breast cancer patients with one or two positive sentinel lymph nodes

Background: Carcinoma of the breast is one of the most common malignancies of women in our country. The current study was conducted with the objective of assessing Oestrogen receptor (ER) and progesterone receptor (PR) status of carcinoma breast for correlation with age of the patient, tumor dimension, axillary lymph node metastasis and histologic grade. Methodology: One hundred and nineteen female breast cancer patients operated at the surgical oncology department of National Institute of Cancer Research & Hospital were selected by non-probability sampling method and operated specimens were sent for immunohistochemical study of the Oestrogen receptor and progesterone receptors. Statistical analysis was conducted using SPSS version 12 for Windows software. P-value 0.05 or less was considered as significant. Result: Mean age of the patients was 41.64 years (95 % Cl 39.8, 43.5). About 87% of the ER+ and PR+ patients had tumour dimension < 5 cm. The predominant morphology was infiltrating duct cell carcinoma. Out of 66 ER+ cases 63 were the patients of Infiltrating duct cell carcinoma and in 63 PR+ cases 60 were the patients of same histological type. The majority of the cases presented as grade II (59.1%) followed by grade Ill (33.9%). Sixty percent patients had axillary lymph node metastasis. Majority of the patients (51.3%) expressed both the receptors in their breast tissue while around 43% of the patients did not show any receptor. Conclusion: ER and PR expression in breast cancers in the current study was found to be comparable to published national and international data. Assessment of prognostic markers for the clinical management of breast cancer patients is strongly advocated to provide best therapeutic options. Journal of Surgical Sciences (2013) Vol. 17 (2) : 84-88

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Prediction of the non-sentinel node metastasis in patients without clinically axillary lymph node metastasis, with implication of breast cancer subtypes.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e13060 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e13060-e13060

Author(s):

Shusei Tominaga

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Node Metastasis ◽

Axillary Lymph Node ◽

Axillary Lymph Node Metastasis ◽

Axillary Lymph ◽

Breast Cancer Patients ◽

Luminal A ◽

Node Metastasis

e13060 Background: The accuracy of the nomogram about non-sentinel lymph node metastasis (NSLNM ) in breast cancer patients is still controversial to avoid axillary dissection particularly sentinel lymph node biopsy was positive. The aim of this study was to evaluate the necessity of adding breast cancer subtypes to the NSLNM nomgram variables. Methods: Between 2009 and 2011, consecutive breast cancer patients without clinically axillary lymph node metastasis (n=140) who received sentinel lymph node biopsy at Higashiosaka General Hospital were studied retrospectively. Twenty-two patients were turned out that breast cancer already spread to the sentinel nodes and all of 22 patients received complete axillary lymph node dissection. Results: Twelve patients had only sentinel lymph node metastases(Group S), 10 patients had non-SLN metastases (Group A). Patient characteristics and average probability of spread to additional lymph node developed by Memorial Sloan-Kettering Cancer Center (MSKCC) Nomogram were almost the same results in both groups. However, subtypes of Group S consisted of 8 HER2 positive , 2 triple negative, and 2 luminal A cases, subtypes of Group A consisted of 4 luminal A and 6 luminal B cases. Conclusions: Our data suggested that luminal type breast cancer tends to spread to non-sentinel lymph node metastasis and adding HER2, Ki-67, and intrinsic biological subtypes may improve predictivity of MSKCC nomogram.

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