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

2005 ◽  
Vol 23 (7) ◽  
pp. 1379-1389 ◽  
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.

scholarly journals The predictors and the prognostic significance of axillary lymph nodes involvement in breast cancer

2019 ◽  
Vol 6 (5) ◽  
pp. 1641 ◽  
Author(s):  
Amine Mohammed Bakkour ◽  
Mohammed Hillu Surriah ◽  
Amir Naif Kadum Al-Imari ◽  
Riad Rahman Jallod Al-Asadi
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Axillary Lymph Node ◽  
Prognostic Significance ◽  
Lymph Node Involvement ◽  
Axillary Lymph ◽  
Axillary Lymph Node Metastases ◽  
Node Involvement ◽  
Poorly Differentiated ◽  
Axillary Lymph Node Involvement

Background: Breast cancer is the most common cancer among women worldwide. The presence of axillary lymph node metastases in breast cancer is an important factor in assessing prognosis and determines management after surgery. The study aimed at identification of the factors that predict axillary lymph node involvement in CA breast. Addressing the prognostic effect of axillary lymph node involvement in turn of predicting the recurrence of CA breast.Methods: This is a prospective review of one hundred cases of Ca breast who have underwent modified radical mastectomy and axillary clearance at Al-Karama Teaching Hospital during the period from January 2014 to December 2018.Results: Positive axillary involvement was found in (74/100, 74%). The highest occurrence of positive axilla was found in (less than 30 and 30-39 years) age groups (27/74, 36%) with the outer quadrants (upper and lower) constituting the majority (50/74, 68%). Positive axillary involvement was mostly notified in tumor grade T4 (39/74, 53%) and in poorly differentiated lesions (47/74, 64%). The highest recurrence rate was found in patients with positive axillary metastases (12/74, 16%), nodal involvement of ten or more nodes (9/41, 22%), nodes with extracapsular extension (10/51, 20%) and in patients who have not taken and/or completed their chemo-radiation sessions (9/11, 82%).Conclusions: Positive axillary lymph node involvement was seen mostly in: young age patients, outer quadrant lesions, tumors with skin involvement, and poorly differentiated lesions.

scholarly journals Real-World Data Related to Non-Metastatic Breast Cancer in Young Women: Experience of a Single Institution

2018 ◽  
Vol 64 (1) ◽  
pp. 45-53
Author(s):  
Juliana Cunha e Silva Ominelli De Souza ◽  
Andrew Sá Nunes ◽  
Jesse Lopes Da Silva ◽  
Aline Coelho Gonçalves ◽  
Suzanne Crocamo Ventilari Da Costa
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Lymph Node ◽  
Young Women ◽  
Advanced Disease ◽  
Young Patients ◽  
Metastatic Breast ◽  
Lymph Node Involvement ◽  
Axillary Lymph ◽  
Node Involvement

Introduction: Breast cancer is the leading cause of cancer-related deaths in women aged 20-59 years. Younger women usually have more aggressive tumors and more advanced disease with larger size and axillary lymph node involvement. There have been few studies assessing the characteristics of breast cancer in very young women. Objective: Evaluate the epidemiological and clinical profile of non-metastatic very young patients with breast cancer. Method: We performed a retrospective analysis to evaluate the epidemiological and clinical profile of non-metastatic breast cancer in patients ≤ 30 years of age treated between 1993 and 2011 at the Brazilian National Cancer Institute José Alencar Gomes da Silva. We evaluated relapse-free survival (RFS) and overall survival (OS). Results: Of the 196 patients evaluated, 181 (90%) had ductal carcinoma, 79 (40%) had high-grade tumors, and 102 (52%) had hormone receptor-positive tumors. 117 patients(60%) had stage III disease at diagnosis. The median age was 29 years (range, 17-30 years). Of 185 patients who underwent surgery, 156 (84.3%) underwent total mastectomy and 171 (92%) underwent axillary lymph node dissection. 119 patients received neoadjuvant chemotherapy, and 14 patients (9.3%) underwent neoadjuvant radiotherapy. After a median follow-up of 81.5 months, 109 patients (55%) had relapsed and 81 (41%) had died. The median RFS and OS were 49.5 months and 134 months, respectively. Lymph node involvement and neoadjuvant chemotherapy were associated with shorter RFS and OS. Conclusion: Breast cancer is uncommon in young patients, especially in those ≤ 30 years of age. We found a predominance of locally advanced disease and worse prognostic pathological characteristics. Despite the aggressive treatment, our patients had worse outcomes than those reported by other authors.

Sentinel lymph node involvement—a predictor for axillary node status with breast cancer—Has the time come?

1998 ◽  
Vol 24 (3) ◽  
pp. 166-168 ◽  
Author(s):  
M. Koller ◽  
D. Barsuk ◽  
D. Zippel ◽  
S. Engelberg ◽  
G. Ben-Ari ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Node Involvement ◽  
Axillary Node ◽  
Node Status ◽  
Node Involvement

scholarly journals Predictive Value of Tumor Load in Breast Cancer Sentinel Lymph Nodes for Second Echelon Lymph Node Metastases

2007 ◽  
Vol 29 (6) ◽  
pp. 497-505
Author(s):  
C. H. M. van Deurzen ◽  
R. van Hillegersberg ◽  
M. G. G. Hobbelink ◽  
C. A. Seldenrijk ◽  
R. Koelemij ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Invasive Breast Cancer ◽  
Primary Tumor ◽  
Lymph Node Involvement ◽  
Consecutive Series ◽  
Axillary Lymph ◽  
Tumor Load ◽  
Node Involvement

Background: The need for routine axillary lymph node dissection (ALND) in patients with invasive breast cancer and low-volume sentinel node (SN) involvement is questionable. Accurate prediction of second echelon lymph node involvement could identify those patients most likely to benefit from ALND.Methods: A consecutive series of 317 patients with invasive breast cancer and a tumor positive axillary SN followed by ALND was reviewed. Clinicopathologic features of the primary tumor and the SN were assessed as possible predictors of second echelon lymph node involvement.Results: Second echelon metastases were found in 116/317 cases (36.6%). Frequency of second echelon lymph node involvement in patients with isolated tumor cells (ITC, N = 23), micro- (N = 101) and macrometastases (N = 193) was 13%, 20% and 48%, respectively (p < 0.001). Based on the area % of SN occupied by tumor no subgroup of patients could be selected with less than 20% second echelon lymph node involvement. However, none of the patients with SN ITC or micrometastases and a primary tumor size ≤1 cm (N = 12, 3.8%) had second echelon lymph node involvement.Conclusions: Accurately measured SN tumor load predicts second echelon lymph node involvement. However, even in patients with ITC, the second echelon lymph nodes are involved in 13% justifying ALND.

scholarly journals Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes

Cancers ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 83
Author(s):  
Zsuzsanna Iyizoba-Ebozue ◽  
Louise J. Murray ◽  
Moses Arunsingh ◽  
Karen E. Dyker ◽  
Sriram Vaidyanathan ◽  
...  
Keyword(s):  
Lymph Node ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Concurrent Chemotherapy ◽  
Oropharyngeal Carcinoma ◽  
Retropharyngeal Lymph Node ◽  
Significant Difference ◽  
Node Involvement ◽  
Fdg Pet Ct ◽  
The Impact

The influence of retropharyngeal lymph node (RPLN) involvement on prognosis in oropharyngeal carcinoma remains poorly defined. The aim of this study was to assess the impact of RPLN involvement upon outcomes. A single-centre retrospective analysis of 402 patients with oropharyngeal carcinoma treated nonsurgically between 2010 and 2017 was performed. All had a baseline 2-[fluorine-18]-fluoro-2-deoxy-d-glucose (FDG) PET-CT and contrast-enhanced MRI and/or CT. RPLN status was determined by radiology review of cases with reported abnormal RPLN. Multivariate backwards logistic regression was used to examine impact on outcomes of factors. Abnormal RPLNs were identified in 40/402 (10%) of patients. Median follow up was 42.9 months. RPLN involvement was associated with inferior 3 year outcomes for overall survival (OS) (67.1% vs. 79.1%, p = 0.006) and distant metastases-free survival (DMFS) (73.9% versus 88.0%, p = 0.011), with no significant difference in local control (81.6% vs. 87.7%, p = 0.154) or regional control (80.7% vs. 85.4%, p = 0.252). On multivariate analysis abnormal RPLN, no concurrent chemotherapy and ongoing smoking were associated with inferior DMFS and OS, while advanced T stage was also associated with inferior OS. In summary, RPLN involvement, present in 10% of patients, was an independent prognostic factor for the development of distant disease failure translating into inferior OS. These findings need confirmation in future studies.

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