Impact of size of the tumor, persistence of estrogen receptors, progesterone receptors, HER2neu receptors and Ki67 values on positivity of axillar lymph nodes at patients with early breast cancer with clinically negative axillar examination (original) (raw)
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PRILOZI, 2017
Aim: The aim of the study was to identify the impact of T stage, the presence of estrogen, progesterone, HER2neu receptors and the values of the Ki67 on the positivity for metastases of the axillary lymph nodes, from primary breast cancer. Material and methods: 290 surgically treated patients for breast cancer were included in the study. All cases have been analyzed by standard histological analysis including microscopic analysis on standard H&E staining. For determining the molecular receptors - HER2neu, ER, PR, p53 and Ki67, immunostaining by PT LINK immunoperoxidase has been done. Results: Patients age was ranged between 18-90 years, average of 57.6+11.9. The mean size of the primary tumor in the surgically treated patient was 30.27 + 18.3 mm. On dissection from the axillary pits 8 to 39 lymph nodes were taken out, an average of 13.81+5.56. Metastases have been found in 1 to 23 lymph nodes, an average 3.14+4.71. In 59% of the patients there have been found metastases in the axill...
Bagcilar Medical Bulletin
Objective: We aimed to evaluate the effect of hormone receptor and immunohistochemistry data on the incidence of primary tumor type and lymph node positivity in breast cancer cases. Method: Demographic, immunohistochemical data of 62 patients who were biopsied in the institute's interventional radiology clinic and long axis of primary tumor in ultrasonography (USG) were retrospectively evaluated. Results: The age of the patients, cell type, c-erb B-2 score and axillary lymph node positivity were not significantly correlated with the assessed data, whereas the long axis of primary tumor, estrogen and progesterone receptor severity and prevalence, ki-67 proliferation index affected lymph node involvement ratio. Conclusion: Evaluation of lymph node involvement with second-line detailed USG before the operation, especially in malignant tumors refer to surgical or interventional radiology departments with negative, high ki-67 PI and C-erb B-2 values in estrogen and progesterone receptors, and the presence of recent axillary USG examination of the cases for breast biopsy regardless of the results, will provide important contribution in the diagnosis and treatment stages.
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.
Archives of Gynecology and Obstetrics, 1998
Objective: Adjuvant treatment for patients with axillary node negative (ANN) breast cancer is controversial because operation alone gives a 70% cure rate. Features which predict recurrence are needed and we therefore evaluated the predictive value of tumor diameter and vascular involvement as well as of estrogen receptors (ER), progesterone receptors (PR), p53, MIB-1, c-erb and PCNA demonstrated by immunohistological staining in 178 patients with ANN breast cancer. Although ER status, tumor diameter and vascular space involvement were significantly correlated to the development of recurrence, their sensitivity, specificity and predictive value were too low to give them clinical value.
Criteria for prediction of metastatic axillary lymph nodes in early-stage breast cancer
Revista Brasileira de Ginecologia e ObstetrÃcia, 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.
Strahlentherapie und Onkologie, 2005
Background and Purpose: The increasing use of systemic adjuvant therapy even in lymph node-negative breast cancer patients and breast cancer screening programs detecting smaller tumors with less probability of metastatic lymph nodes questions the need for routine axillary lymph node dissection. Since morbidity of breast cancer surgery is predominantly related to axillary lymph node dissection, predictive models for lymph node involvement may provide a way to avoid lymph node surgery and its side effects in subgroups of patients. Patients and Methods: Using a multivariate logistic regression model, tumorbiological parameters such as expression of estrogen and progesterone receptors, Ki-67, p53, cathepsin D, HER2, S-phase fraction, and ploidy were analyzed regarding their ability to predict axillary lymph node involvement in 655 breast cancer patients. Results: The model correctly predicted axillary lymph node metastases in 58% of the patients by including expression of progesterone receptor, HER2, and Ki-67. In a subgroup of 200 patients predicted to be at extremely high or extremely low risk for axillary lymph node metastases, the accuracy of the prediction was 70%. Conclusion: With a model just based on tumorbiological parameters obtained in the primary tumor it is possible to predict axillary lymph node status. By including additional parameters it appears to be feasible to further improve the model in order to avoid axillary lymph node surgery in low-risk women.
Breast Cancer Research and Treatment
To evaluate the differences when performing the sentinel lymph node biopsy (SLNB) before or after neoadjuvant endocrine therapy (NET) in breast cancer patients, and the impact of its timing on prognosis. Methods A retrospective cohort study including 91 postmenopausal cases with clinically node-negative and hormone receptor-positive/HER2 negative (HR+/HER2-) breast cancer, treated with NET and SLNB at our institution. SLNB was performed pre-NET until 2014, and post-NET thereafter. Axillary lymph node dissection (ALND) was indicated only in SLNB-macrometastasis, although in selected elderly patients it was omitted. Kaplan-Meier survival curves were obtained in relation to the status of the axilla, and the differences assessed using the log-rank test. Results Between December 2006 and March 2022, SLNB was performed pre-NET in 14 cases and post-NET in 77. SLNB-positivity was similar regardless of whether SLNB was performed before or after NET (35.7% and 37%, respectively), with 2/14 SLN macrometastases in the pre-NET cohort and 17/77 in the post-NET cohort. Only three patients (18.7%) with SLN macrometastasis had > 3 positive nodes following axillary node dissection. The 5-year overall survival and distant disease-free survival were 92.4% and 94.8% respectively, with no signi cant differences according to SLNB status. Conclusion SLN positivity did not differ according to its timing (before or after NET). Therefore, NET has no effect on lymph node clearance. Furthermore, the prognosis is good regardless of the axillary involvement. Therefore, factors other than axillary involvement may affect the prognosis in these patients.
Prediction of Axillary Lymph Node Metastases in a Screened Breast Cancer Population
Acta Oncologica, 1994
To define a subgroup of patients, in whom axillary dissection could be omitted, we analysed the frequency of pathologically confirmed lymph node metastases depending on tumour size, hormonal receptors, DNA ploidy, S-phase fraction (SPF), and clincial nodal status among 1 145 patients with stage 1-11 breast cancer from an area with ongoing screening. Clinical nodal status and tumour size were strongly correlated to pathological nodal status. Also SPF > 10% was strongly correlated to node positivity in univariate analysis. In multivariate analysis there was still a significant correlation among cases with tumour size < 20mm. In conclusion, patients with clincially negative nodal status, and tumour size < 20 mm and < 10 mm had pathologically positive nodes in 25% and 15% of cases respectively. The addition of SPF did not lower these figures significantly since small tumours with high SPF are few.
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...