Prognostic Factors on the Positivity for Metastases of the Axillary Lymph Nodes from Primary Breast Cancer (original) (raw)
Related papers
Open Access Macedonian Journal of Medical Sciences
Aim: The aim of the study was to identify factors that influence the positivity on axillar status at patients with early breast cancer with clinical negative axilla, at which were done radical surgery to breast but also radical lymphadenectomy of axillar lymph nodes.Material and methods: In the study were included 81 surgically treated patients with early breast cancer during 08-2015 to 05-2017 year. All the cases have been analyzed by standard histological analysis including macroscopic and microscopic analysis on standard H&E staining. For determining of molecular receptors immunostaining by PT LINK immunoperoxidase has been done for HER2neu, ER, PR, p53 and Ki67. Results: Patients age ranged between 31-73 years, average of 56.86 years. The mean size of the primary tumor in the surgically treated patient was 20.33 + 6.0 mm. On dissection from the axilary pits there were taken out 5 to 32 lymph nodes, an average of 14. Metastases have been found in 1 to 7 lymph nodes, an average ...
Archives of Clinical and Experimental Medicine
Aim: Axillary status evaluation and, if present, the number of metastatic lymph nodes is important in staging and adjuvant therapy planning of breast cancer. A number of clinical and pathological variables were analyzed to detect factors affecting nodal status. Methods: A total of 298 women with unilateral breast cancer operated with axillary lymph node dissection or sentinel lymph node biopsy, were retrospectively analyzed for age, localization, BIRADS category, pathological features, subtypes as Luminal A, Luminal B, HER2 positive, triple negative, Ki-67 index and number of lymph nodes involved. Results: The mean age was 54.7 years. BIRADS 5 was the most detected category in 208 (69.8%) patients. The most common pathological type was invasive ductal carcinoma in 265 patients (88.9%). The most detected tumor grade was grade 2 in 160 (31.2%). Luminal B was the most common subtype and detected in 173 patients (58.1%). Ki-67 indexes were detected between 0-14% in 69 patients (23.3%), between 15-19% in 31patients (10.4%) and above 20% in 198 patients (66.4%). Conclusions: HER2 positivity, Ki-67 index, and progesterone receptor negativity are the most significant factors affecting axillary lymph node metastasis.
Criteria for prediction of metastatic axillary lymph nodes in early-stage breast cancer
Revista Brasileira de Ginecologia e Obstetrícia, 2015
PURPOSE: To estimate the likelihood of axillary lymph node involvement for patients with early-stage breast cancer, based on a variety of clinical and pathological factors. METHODS: A retrospective analysis was done in hospital databases from 1999 to 2007. Two hundred thirty-nine patients were diagnosed with early-stage breast cancer. Predictive factors, such as patient age, tumor size, lymphovascular invasion, histological grade and immunohistochemical subtype were analyzed to identify variables that may be associated with axillary lymph node metastasis. RESULTS: Patients with tumors that are negative for estrogen receptor, progesterone receptor, and HER2 had approximately a 90% lower chance of developing lymph node metastasis than those with luminal A tumors (e.g., ER + and/or PR + and HER2 -) -Odds Ratio: 0.11; 95% confidence interval: 0.01-0.88; p=0.01. Furthermore, the risk for lymph node metastasis of luminal A tumors seemed to decrease as patient age increased, and it was directly correlated with tumor size. CONCLUSION: The molecular classification of early-stage breast cancer using immunohistochemistry may help predicting the probability of developing axillary lymph node metastasis. Further studies are needed to optimize predictions for nodal involvement, with the aim of aiding the decision-making process for breast cancer treatment.
PURPOSE: To estimate the likelihood of axillary lymph node involvement for patients with early-stage breast cancer, based on a variety of clinical and pathological factors. METHODS: A retrospective analysis was done in hospital databases from 1999 to 2007. Two hundred thirty-nine patients were diagnosed with early-stage breast cancer. Predictive factors, such as patient age, tumor size, lymphovascular invasion, histological grade and immunohistochemical subtype were analyzed to identify variables that may be associated with axillary lymph node metastasis. RESULTS: Patients with tumors that are negative for estrogen receptor, progesterone receptor, and HER2 had approximately a 90% lower chance of developing lymph node metastasis than those with luminal A tumors (e.g., ER + and/or PR + and HER2-) – Odds Ratio: 0.11; 95% confidence interval: 0.01–0.88; p=0.01. Furthermore, the risk for lymph node metastasis of luminal A tumors seemed to decrease as patient age increased, and it was directly correlated with tumor size. CONCLUSION: The molecular classification of early-stage breast cancer using immunohistochemistry may help predicting the probability of developing axillary lymph node metastasis. Further studies are needed to optimize predictions for nodal involvement, with the aim of aiding the decision-making process for breast cancer treatment. Resumo OBJETIVO: Estimar a probabilidade de acometimento linfonodal em pacientes com câncer de mama inicial, baseado em fatores clínicos e patológicos. MÉTODOS: Foi realizada uma análise retrospectiva de 1999 a 2007 dos bancos de dados do hospital. Um total de 239 pacientes foram diagnosticados com câncer de mama em estádio inicial. Fatores preditivos como idade, tamanho do tumor, presença de invasão linfovascular, grau histológico e subtipo imunoistoquímico foram analisados para identificar possíveis variáveis associadas com a presença de metástases axilares. RESULTADOS: Pacientes com tumores negativos para receptor de estrogênio, receptor de progesterona e HER2 tiveram aproximadamente 90% menos chance de terem metástases axilares do que pacientes com tumores luminais A (por exemplo, ER + e/ou PR + e HER2-) – Odds Ratio: 0,11; intervalo de confiança de 95%: 0,01–0,88; p=0,013. Além disso, o risco de metástases axilares para tumores luminais A diminuiu com o aumento da idade e se correlacionou diretamente com o tamanho do tumor. CONCLUSÃO: A classificação molecular do câncer de mama em estádio inicial utilizando a imunoistoquímica pode ajudar a predizer a probabilidade de encontrar metástases axilares. Novos estudos são necessários para otimizar essa predição, auxiliando no processo de decisão do tratamento relacionado ao câncer de mama.
Applied Immunohistochemistry & Molecular Morphology, 2017
Background: We aimed to demonstrate that in breast carcinomas the tumor profile is not stable during the metastatic process, with impact on therapeutic decisions. Materials and Methods: We analyzed the estrogen receptor (ER), progesterone receptor (PR), and HER2 status and Ki67 index in 41 primary unifocal (PU) and 37 primary multiple (PM) breast carcinomas with identical immunohistochemical profiles among multiple tumor foci and the matched axillary lymph node metastases. We defined as concordant cases in which the primary tumor (PU or PM) and lymph node metastases displayed identical positivity or negativity for ER, PR, HER2, Ki67 and as discordant cases in which there was a mismatch in at least 1 biological parameter among PU and PM tumor and lymph node metastases. Moreover, we defined as concordant cases in which the molecular profile (based on the immunohistochemical evaluation of ER, PR, HER2, and Ki67) was concordant among PU and PM tumors and lymph node metastases and mismatch cases as those in which the molecular profile of the primary tumor differs from one of the lymph node metastases in at least 1 lymph node. Results: The positivity for the biological markers is not stable during the metastatic process. In this study the total rate of discordant cases was 92.7% in PU tumors and 75.7% in PM homogenous tumors (P = 0.058, odds ratio = 0.245, 95% confidence interval, 0.06-0.991). The total rate of shifted cases was 64.9% in PM tumors and 82.9% in PU tumors. The highest rate of shifting was encountered from Luminal B-like to Luminal Alike. In 11 out of 37 (29.7%) PM and in 17 out of 41 (41.5%) PU cases the subtype shifted to a poorer one with respect to prognosis. Conclusions: The patients in whom the primary tumor is hormone receptor and/or HER2 negative but is positive for these markers in the axillary lymph nodes could become eligible for hormonal treatment and/or trastuzumab treatment, which may significantly improve the patient's outcome.
Significance of Axillary Lymph Node Metastasis in Primary Breast Cancer
Journal of Clinical Oncology
PURPOSE: Axillary lymph node status is the single most important prognostic variable in the management of patients with primary breast cancer. Yet, it is not known whether metastasis to the axillary nodes is simply a time-dependent variable or also a marker for a more aggressive tumor phenotype. The purpose of this study was to determine whether nodal status at initial diagnosis predicts outcome after relapse and therefore also serves as a marker of breast cancer phenotype. PATIENTS AND METHODS: Survival experience after first relapse in 1,696 primary breast cancer cases was analyzed using Cox proportional hazards regression. The following explanatory variables and their first-order interactions were considered: number of axillary lymph nodes involved (zero v one to three v four or more), hormone receptor status (any estrogen receptor [ER] negativity v ER negativity/progesterone receptor positivity v other ER positivity), primary tumor size (< 2 cm v 2 to 5 cm v > 5 cm), site ...
Quantitative evaluation of metastases in axillary lymph nodes of breast cancer
British journal of cancer, 2003
We have established a highly sensitive and quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) method to detect axillary lymph node metastases of breast cancer. Amplifying cytokeratin 19 (CK19) mRNA transcripts using real-time TaqMan PCR made it possible to quantify axillary metastatic burden. Metastases in 358 axillary lymph nodes obtained from 23 breast cancers of 22 patients were investigated by conventional haematoxylin and eosin (H&E) staining, immunohistochemical staining and quantitative RT-PCR assay. The detection rates of axillary lymph node metastasis using H&E staining, immunohistochemistry and RT-PCR assay were 4.5, 5.9 and 13.1%, respectively. RT-PCR assay was the most sensitive of these three methods for detecting lymph node metastases. Cytokeratin 19 mRNA expression values of both histologically and immunohistochemically positive lymph nodes were significantly higher than the values for lymph nodes judged to be negative by both histological and immun...
Axillary Lymph Node Status in Primary Breast Carcinoma
The Professional Medical Journal, 2015
Objectives: The most important prognostic factor in patients of breast carcinomais axillary lymph node metastasis. Current study was conducted to find the frequency of lymphnode metastasis in hundred cases of primary breast carcinoma and association of lymphnode status with immunohistochemical expression of ER/PR,HER2/neu and MMP-1(matrixmetalloproteinase-1).Design: Descriptive study. Period: Aug 2012 to Jun 2013. Setting: U.H.Slaboratory of Morbid Anatomy and Histopathology Lahore. Materials and methods:Onehundred mastectomy specimens with axillary lymph node dissection were included. Aftergross examination, tissue processing and microtomy the tissue slices of 4 micrometer weretaken on frosted and lysine coated slides. H/E and IHC for ER/PR,HER2/neu and MMP-1 weredone according to protocol. Results: Among 100 breast cancer subjects, 72 were positivefor lymph node metastasis while 28 subjects were negative. A significant association betweenlymph node status and ER IHC expression was...
Journal of the Egyptian National Cancer Institute, 2011
It was observed during dissection of heavy deposits of axillary lymph nodes (LNs) in breast cancer that there were grossly positive LNs outside the confines of classical axillary dissection. To know the extent of LN metastases in these new basins by dissecting and labeling them separately, for pathological examination and proper staging of those patients. From 2005 to 2009, 59 private patients with breast cancer who had positive axillary LNs were subjected to axillary dissection with accurate leveling according to its relation to pectoralis minor. In addition to the classical three levels, the brachial, thoracoacromial, humeral, scapular and Rotter's lymph nodes were dissected. Levels I, II and III axillary LNs were involved in 91.5%, 62.7%, and 52.5%, respectively. Skip metastases (without the involvement of level one) were found in 5/59 patients (8.4%). Brachial, acromiothoracic, humeral and Rotter's LNs were involved in 10.1%, 15.2%, 5% and 1.7%, respectively, with no met...
Diagnostic pathology, 2011
While several prognostic factors have been identified in breast carcinoma, the clinical outcome remains hard to predict for individual patients. Better predictive markers are needed to help guide difficult treatment decisions. Axillary lymph node metastasis (ALNM) is one of the most important prognostic determinants in breast carcinoma; however, the reasons why tumors vary in their capability to result in axillary metastasis remain unclear. Identifying breast carcinoma patients at risk for ALNM would improve treatment planning. This study aimed to identify the factors associated with ALNM in breast carcinoma, with particular emphasis on basal-like phenotype. Breast carcinoma patients (n = 210) who underwent breast conserving surgery and axillary lymph node dissection (ALND) (level I and II) or modified radical mastectomy were included in this study. Pathological and immunohistochemical data including individual receptor/gene status was collected for analysis. The basal phenotype sta...