The relationship of p53 Protein and lymph node metastases in invasive breast cancer

55 Background: It has previously been demonstrated that mammographically-detected breast cancers present as earlier stage disease than those detected as a palpable finding. In addition, it is well known that the single most important prognostic indicator in breast cancer is lymph node status. The benefit of screening mammography in women age 40-49 has been questioned recently, and has led to a change in the recommendations by the United States Preventative Services Task Force (USPSTF) to begin screening mammography in the average risk woman at age 50, rather than 40. In this study, we sought to determine whether detection of breast cancer in 40-49 year old women by screening mammography is associated with negative nodal status at presentation. Methods: A prospectively collected database was reviewed to identify 460 women ages 40-49 diagnosed with invasive breast cancer from 2003-2008. The method of detection of the breast cancer was noted, and the lymph node status at presentation was identified. Results: There were 460 eligible patients with invasive breast cancer for whom information regarding nodal status was available. Of these, 205 patients were diagnosed with a mammographic finding, and 255 patients presented with a palpable abnormality. In the group whose cancers were detected on mammography, 18% presented with lymph node metastases. This is significantly lower than the 41% who presented with a palpable finding (p<0.0001). For 40-49 year old women with invasive breast cancer, the likelihood of having a positive lymph node at presentation is 3.2 times higher if her cancer is detected as a palpable abnormality rather than on mammography (odds ratio) (CI: 2.1-5.0) (Table). Conclusions: Our analysis demonstrates that a patient diagnosed with invasive breast cancer in her 40s is more likely to present with lymph node metastases if her cancer is detected as a palpable mass, compared to those detected on mammography. This has certain prognostic importance, and provides an additional rationale for performing screening mammography in women of this age group. [Table: see text]

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A multivariate study of the relationship between regional lymph node metastases and prognosis in patients with operable breast cancer

The Japanese Journal of Surgery ◽

10.1007/bf02471045 ◽

1991 ◽

Vol 21 (6) ◽

pp. 613-620 ◽

Cited By ~ 4

Author(s):

Masakuni Noguchi ◽

Takao Taniya ◽

Naohiro Koyasaki ◽

Nagayoshi Ohta ◽

Itsuo Miyazaki

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Node Metastases ◽

Regional Lymph Node ◽

Operable Breast Cancer ◽

Multivariate Study ◽

Node Metastases ◽

The Relationship

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Factors correlating with lymph node metastases in patients with T1 ductal invasive breast cancer

Archive of oncology ◽

10.2298/aoo0602019i ◽

2006 ◽

Vol 14 (1-2) ◽

pp. 19-22 ◽

Cited By ~ 3

Author(s):

Tatjana Ivkovic-Kapicl ◽

Milana Panjkovic ◽

Dejan Nincic ◽

Slavica Knezevic-Usaj

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Protein Expression ◽

Lymph Node Metastases ◽

Tumor Size ◽

P53 Protein ◽

Proliferation Index ◽

Ki 67 ◽

Receptor Status ◽

Node Metastases

BACKGROUND: Identification of reliable predictors of axillary lymph node metastases (ALNM) may be useful in selecting appropriate management for patients with T1-size breast cancer. This study was undertaken to determine the association between ALNM and several variables, including age, tumor size, grade, estrogen receptor status, progesterone receptor status, p53 and c-erbB2 protein expression, and Ki-67 proliferative index. METHODS: In a retrospective study, 74 patients with pT1b and pT1c ductal invasive breast carcinoma and with known nodal status were analyzed. The size of the infiltrating tumor was microscopically evaluated. The histological grading was performed using the modified criteria of Bloom and Richardson, as described by Elston and Ellis. The immunophenotype of the tumor was determined as: the expression of estrogen (ER) and progesterone (PR) receptors, p53, c-erbB2 and Ki-67. The patients were grouped by age as follows: <50, 50-70, and >70 years old. RESULTS: Twenty six patients (35%) were node positive. Tumor size was related directly to nodal positivity. Nodal positivity was significantly related to negative PR status, p53 protein overexpression and high Ki-67 index (p<0.05). No significant association was found between nodal positivity and patient age, tumor grade, ER status, and c-erbB2 expression. CONCLUSION: These data suggest that PR status, Ki-67 proliferation index, and p53 protein expression might provide additional information to the lymph node status in T1 ductal breast carcinomas.

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