P062. Ultrasound-guided core biopsy proven lymph node involvement predicts heavy nodal status at axillary node clearance in patients with early breast cancer

1602 Background: Independent from known prognostic factors, e.g., tumor size and nodal status, obesity is a risk factor for poor disease free, distant disease free, and overall survival in breast cancer. The aim of this analysis was to examine the correlation of the body mass index (BMI) with tumor characteristics in early breast cancer. Methods: We analyzed the data of 7,997 pts with early, node positive or high risk node negative primary breast cancer treated with adjuvant taxan-based chemotherapy within the German multicenter phase III SUCCESS A, B, or C trials. The pts’ tumor stage at primary diagnosis was classified according to the UICC tumor-node-metastasis (TNM) classification. Additionally, the tumor’s hormone-receptor status and HER2/neu status were determined. Before enrollment into the study each patient was grouped according to the WHO global database on BMI. Contingency table methods were used to analyze the correlation of BMI and tumor characteristics. Results: Among the 7,997 pts 100 (1.3%) pts were underweight, 3,556 (44.5%) pts were normal weight, 2,569 (32.1%) pts were overweight and 1,772 (22.2%) were obese. Of all pts 4,508 pts (56.4%) suffered from a pT2-4 tumor, 4830 (60.4%) showed lymph node involvement (pN1-3) and 7509 (93.9%) had G2-3 tumors. 5839 pts (73.0%) showed positivity for ER or PR and 935 (11.7%) for HER2/neu. Overweight and obese pts had significantly larger tumors compared to pts with normal BMI (p<0.0001; p<0.0001). Furthermore, overweight and obesity were associated with a significantly higher rate of lymph node involvement (p=0.0001; p=0.0003) respectively. In contrast neither grading, tumor histology, ER/PR-status nor HER2/neu-overexpression were correlated with BMI. Conclusions: These data are the first to show in a large number of pts that both obese and overweight women suffering from primary breast cancer have significantly larger tumors and more often positive axillary lymph nodes. As there are no differences in tumor biology, the advanced tumor stage might be due to more difficult and delayed detection of breast cancer and lymph node lesions in these women.

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Establishment of Simple Nomograms for Predicting Axillary Lymph Node Involvement in Early Breast Cancer

Cancer Management and Research ◽

10.2147/cmar.s241641 ◽

2020 ◽

Vol Volume 12 ◽

pp. 2025-2035

Author(s):

Qingqing Zong ◽

Jing Deng ◽

Wanli Ge ◽

Jie Chen ◽

Di Xu

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Early Breast Cancer ◽

Axillary Lymph Node ◽

Lymph Node Involvement ◽

Axillary Lymph ◽

Node Involvement ◽

Axillary Lymph Node Involvement

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Near-Diploid Hyperploidy in Early Breast Cancer (T1a,b) is Associated with Higher Risk of Lymph Node Involvement

Pathology & Oncology Research ◽

10.1007/s12253-012-9559-z ◽

2012 ◽

Vol 19 (1) ◽

pp. 71-77 ◽

Cited By ~ 1

Author(s):

Joško Bezić ◽

Ivana Šamija-Projić ◽

Petar Projić ◽

Jelena Ljubković ◽

Sandra Tomaš-Zekić ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Early Breast Cancer ◽

Lymph Node Involvement ◽

Node Involvement

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Use of ultrasound-guided axillary node core biopsy in staging of early breast cancer

European Radiology ◽

10.1007/s00330-008-1177-5 ◽

2008 ◽

Vol 19 (3) ◽

pp. 561-569 ◽

Cited By ~ 71

Author(s):

P. D. Britton ◽

A. Goud ◽

S. Godward ◽

S. Barter ◽

A. Freeman ◽

...

Keyword(s):

Breast Cancer ◽

Early Breast Cancer ◽

Core Biopsy ◽

Axillary Node ◽

Ultrasound Guided

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Size of Breast Cancer Metastases in Axillary Lymph Nodes: Clinical Relevance of Minimal Lymph Node Involvement

Journal of Clinical Oncology ◽

10.1200/jco.2005.07.094 ◽

2005 ◽

Vol 23 (7) ◽

pp. 1379-1389 ◽

Cited By ~ 122

Author(s):

Marco Colleoni ◽

Nicole Rotmensz ◽

Giulia Peruzzotti ◽

Patrick Maisonneuve ◽

Giovanni Mazzarol ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Clinical Relevance ◽

Distant Metastases ◽

Lymph Node Involvement ◽

Axillary Node ◽

Axillary Lymph ◽

Axillary Lymph Node Metastases ◽

Significant Difference ◽

Node Involvement

Background Overt ipsilateral axillary lymph node metastases of breast cancer are the most significant prognostic indicators for women who have undergone surgery, yet the clinical relevance of minimal involvement (isolated tumor cells and micrometastases) of these nodes is uncertain. Patients and Methods We evaluated biologic features, adjuvant treatment recommendations, and prognosis for 1,959 consecutive patients with pT1-3, pN0, minimal lymph node involvement (pN1mi or pN0i+), or pN1a (single positive node) and M0, who were operated on and counseled for medical therapy from April 1997 to December 2000. Results Patients with pN1a and pN1mi/pN0i+, when compared with patients with pN0 disease, were more often prescribed anthracycline-containing chemotherapy (39.1% v 33.2% v 6.1%, respectively; P < .0001) and were less likely to receive endocrine therapy alone (9.8% v 19.4% v 41.9%, respectively; P < .0001). At the multivariate analysis, a statistically significant difference in disease-free survival (DFS) and in the risk of distant metastases was observed for patients with pN1a versus pN0 disease (hazard ratio [HR] = 2.04; 95% CI, 1.46 to 2.86; P < .0001 for DFS; HR = 2.32; 95% CI, 1.42 to 3.80; P = .0007 for distant metastases) and for patients with pN1mi/pN0i+ versus pN0 disease (HR = 1.58; 95% CI, 1.01 to 2.47; P = .047 for DFS; HR = 1.94; 95% CI, 1.04 to 3.64; P = .037 for distant metastases). Conclusion Even minimal involvement of a single axillary node in breast cancer significantly correlates with worse prognosis compared with no axillary node involvement. Further studies are required before widespread modification of clinical practice.

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