Age is not a prognostic factor in Korean women with breast cancer treated with breast conservative surgery and radiotherapy

10740 Background: The median age of the breast cancer at diagnosis in Korean women is 45 years and a quarter of the patients are at age 40 or younger. The purpose of this study was to analyze the prognostic factors including age for patients treated with breast conserving surgery and radiotherapy. Methods: Two hundred and eleven breast cancer patients were treated with breast conserving therapy at Soonchunhyang University Hospital, Seoul, Korea, between May 1991 and May 2003. The radiation dose to the whole breast was 50.4 Gy over 5 weeks and boost doses of 10–14 Gy administered to the tumor bed in the majority of the patients (180/211). Nodal radiotherapy was delivered in patients with 4 or more node metastasis. Adjuvant chemotherapy was performed in most of the patients with node metastasis or tumors larger than 1cm, or younger patients. One hundred and thirty four patients received CMF regimen, 14 patients treated with CEF regimen. The median and minimum follow-up periods were 58 and 30 months respectively. Results: The average age at the time of operation was 41.9 years (median 42 years, range 23–67 years), and the mean tumor size was 2.03 cm (median 1.80 cm). One hundred and forty seven patients (69.7%) had pathologically node negative disease and fifteen patients had 4 or more lymph node metastasis. Local, regional relapse and distant metastasis occurred in 7, 3 and 10 patients respectively. The 5 year disease free, loco-regional relapse free and overall survival rate were 89.5%, 93.4%, 95.6%, respectively. Three patients among the 31 patients who received 50.4Gy or incomplete radiotherapy to the breast experienced loco-regional relapse. Age (40 years or less versus more than 40 years old) was not a prognostic factor in univariate analysis. T stage (p = 0.027), lymph node metastasis (p < 0.01) were significant factors for recurrences. By multivariate analysis, only lymph node status was a significant prognostic factor for treatment related failure. Conclusions: A breast conserving procedure is effective for patients with early stage breast cancer regardless of age in Korean women. Axillary lymph node status was the most important independent predictor for a recurrence, and more efficient treatment is required for these patients with lymph node metastasis. No significant financial relationships to disclose.

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Correlation between Grading Histopathology and Sentinel Lymph Node Metastasis in Early Breast Cancer in University of Sumatera Utara Hospital

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6423 ◽

2021 ◽

Vol 9 (B) ◽

pp. 679-682

Author(s):

Dedy Hermansyah ◽

Gracia Pricilia ◽

Arjumardi Azrah ◽

Yolanda Rahayu ◽

Desiree A. Paramita ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Node Metastasis ◽

Axillary Lymph Node ◽

Sentinel Lymph Node Metastasis ◽

Lymph Node Status ◽

Axillary Lymph ◽

Node Metastasis

BACKGROUND: Breast cancer is a malignancy in breast tissue from the duct or lobar epithelium. American Joint Committee on Cancer has specified important prognostic factors such as primary tumor size, regional lymph node status, and distant metastasis. Axillary lymph node status has been one of the most reliable prognostic factors in early breast cancer in women. Axillary lymph node dissection is an old method to identify metastasis in axillary lymph nodes and started being replaced by sentinel lymph node biopsy (SLNB). SLNB has been introduced as a minimal invasive procedure, but in Indonesia, this procedure cannot be done due to technology limitation. Grading tumor is one of the predictor factors that can predict lymph node metastasis. This predictor factor has been associated with sentinel lymph node metastasis significantly. AIM: According to this, we conduct this study to analyze the correlation between grading histopathology in breast cancer with sentinel lymph node metastasis to lower false-negative rate in SLNB using methylene blue dye. MATERIALS AND METHODS: In this study, we included 51 patients that qualified using inclusion and exclusion criteria. Then, sentinel lymph node metastasis and grading histopathology data were retrieved from the patient’s medical record. This data are analyzed using SPSS with Chi-square test. RESULTS: The most type of breast cancer in this study is invasive ductal carcinoma was found in 40 patients (78.4%). There are 22 of 51 patients (51.6%) with metastasis to sentinel lymph node, have Grade 3 in histopathologic findings. CONCLUSIONS: The statistical evaluation showed that there is significant correlation between grading histopathology and SLNB with p = 0.001.

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Lymph node metastasis in breast cancer: The role of tumor markers

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.21019 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 21019-21019

Author(s):

M. J. Lund ◽

S. M. Graham ◽

J. M. Liff ◽

R. J. Coates ◽

E. W. Flagg ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Black Women ◽

Lymph Node Metastasis ◽

Tumor Markers ◽

Lymph Node Status ◽

Node Negative ◽

Node Metastasis ◽

Node Status ◽

Lymph Node Positive

21019 Background: Women diagnosed with lymph node positive breast cancer have a greater chance of recurrence and death than women with lymph node negative disease. Tumor markers are becoming increasingly important to understanding breast cancer progression, yet little is known about their relationship with lymph node status. The purpose of this study is to examine whether prognostic and novel cell-cycle tumor markers are associated with lymph node status in black and white women with invasive breast cancer. Methods: This study included 202 lymph node positive and 292 node negative women, ages 20–54 years, diagnosed with invasive breast cancer between 1990 and 1992, and previously enrolled in a population-based study in Atlanta, Georgia. Tumor specimens were centrally reviewed and evaluated for lymphovascular invasion (LVI) and Nottingham tumor grade. Expression of estrogen and progesterone receptors (ER and PR), c-ErbB-2, Ki-67, pRb, p16, p21, p27, p130/Rb2, p53, cyclin E, and cyclin D1 were centrally assayed by immunohistochemistry. Relationships between each tumor marker and lymph node status were assessed by logistic regression, after adjusting for prognostic and socio-demographic factors. Results: Several tumor markers were associated with lymph node status, but differed by tumor size. Among women with smaller tumors (≤2.0 cm), p130 (OR=0.6, 95% CI 0.4–1.0), Bcl-2 (OR=0.4, 95% CI 0.2–0.8), and cyclin D1 (OR=1.7, 95% CI 1.0–2.8) were significant predictors of positive lymph node status. Among women with tumors > 2.0 cm, p53 (OR=0.5, 95% CI 0.3–0.8), and cyclin E (OR=0.4, 95% CI 0.2–0.9), and pRb (OR=1.6, (95% CI 1.0–2.6) were significant predictors. Black women with smaller tumors were 50% more likely to have lymph node metastasis. LVI and high grade remained the strongest predictors of lymph node metastasis in all regression models. Conclusions: Our findings suggest that there may be a different mechanism for lymph node spread in aggressive smaller tumors compared to larger tumors. Identifying markers for aggressive tumors could lead to the benefit of more effective treatment, particularly among black women for whom race may be a surrogate for other markers not accounted for in our study. No significant financial relationships to disclose.

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Is FDG maximum standardized uptake value of primary breast cancer a prognostic factor for locoregional axillary lymph node metastasis?

Acta Radiologica ◽

10.1177/0284185118824770 ◽

2019 ◽

Vol 60 (10) ◽

pp. 1241-1250

Author(s):

Rania Refaat ◽

Mohammad Abd Alkhalik Basha ◽

Mohammed Sobhi Hassan ◽

Rasha S Hussein ◽

Rania M Al-Molla ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Prognostic Factor ◽

Lymph Node Metastasis ◽

Axillary Lymph Node ◽

Standardized Uptake Value ◽

Axillary Lymph Node Metastasis ◽

Axillary Lymph ◽

Maximum Standardized Uptake Value ◽

Node Metastasis

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AXILLARY LYMPH NODE STATUS IN PRIMARY BREAST CARCINOMA

The Professional Medical Journal ◽

10.29309/tpmj/2015.22.05.1278 ◽

2015 ◽

Vol 22 (05) ◽

pp. 627-631

Author(s):

Farwa Batool Shamsi ◽

Nadia Naseem ◽

A.H. Nagi

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Axillary Lymph Node ◽

Axillary Lymph Node Metastasis ◽

Lymph Node Status ◽

P Value ◽

Axillary Lymph ◽

Chi Square ◽

Node Metastasis ◽

Node Status

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 noticed. When Chi square test was appliedwith p-value of 0.001 was observed.Also a significant association between lymph node statusand PR IHC expression was noticed. Chi square test was applied and the p-value of 0.004 wasobtained.Association between lymph node status and HER2/neu IHC expression was analysed.Chi square test was applied with a p-value of 0.467 was obtained (not significant).A significantassociation between lymph node status and MMP-1 IHC expression was observed. Chi squaretest was applied anda p-value of 0.004 was obtained. Conclusions: Most of the primary breastcarcinomas were presented with axillary lymph node metastasis (72%).Significant associationswere observed between lymph node status and ER/PR immuonohistochemical expressionshowever the association between HER2/neu IHC and lymph node status was not statisticallysignificant. The immunohistochemical expression of MMP-1 is significantly associated withlymph node status. It shows that it is an important marker for metastatic potential in breastcarcinoma.

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A logistic regression nomogram to predict axillary lymph node metastasis in early invasive breast cancer patients

10.26226/morressier.5b4709836f4cb30010951a6e ◽

2018 ◽

Author(s):

Parnaz Daneshpajouhnejad

Keyword(s):

Breast Cancer ◽

Logistic Regression ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Cancer Patients ◽

Invasive Breast Cancer ◽

Axillary Lymph Node Metastasis ◽

Axillary Lymph ◽

Breast Cancer Patients ◽

Node Metastasis

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Radiomics Nomogram of Contrast-Enhanced Spectral Mammography for Prediction of Axillary Lymph Node Metastasis in Breast Cancer: A Multicenter Study

SSRN Electronic Journal ◽

10.2139/ssrn.3469725 ◽

2019 ◽

Author(s):

Ning Mao ◽

Ping Yin ◽

Qin Li ◽

Qinglin Wang ◽

Meijie Liu ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Multicenter Study ◽

Axillary Lymph Node ◽

Axillary Lymph Node Metastasis ◽

Axillary Lymph ◽

Node Metastasis ◽

Contrast Enhanced

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Dedicated Axillary MRI-Based Radiomics Analysis for the Prediction of Axillary Lymph Node Metastasis in Breast Cancer

Cancers ◽

10.3390/cancers13040757 ◽

2021 ◽

Vol 13 (4) ◽

pp. 757

Author(s):

Sanaz Samiei ◽

Renée W. Y. Granzier ◽

Abdalla Ibrahim ◽

Sergey Primakov ◽

Marc B. I. Lobbes ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Axillary Lymph Node ◽

Axillary Lymph Node Metastasis ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Mr Images ◽

Node Metastasis

Radiomics features may contribute to increased diagnostic performance of MRI in the prediction of axillary lymph node metastasis. The objective of the study was to predict preoperative axillary lymph node metastasis in breast cancer using clinical models and radiomics models based on T2-weighted (T2W) dedicated axillary MRI features with node-by-node analysis. From August 2012 until October 2014, all women who had undergone dedicated axillary 3.0T T2W MRI, followed by axillary surgery, were retrospectively identified, and available clinical data were collected. All axillary lymph nodes were manually delineated on the T2W MR images, and quantitative radiomics features were extracted from the delineated regions. Data were partitioned patient-wise to train 100 models using different splits for the training and validation cohorts to account for multiple lymph nodes per patient and class imbalance. Features were selected in the training cohorts using recursive feature elimination with repeated 5-fold cross-validation, followed by the development of random forest models. The performance of the models was assessed using the area under the curve (AUC). A total of 75 women (median age, 61 years; interquartile range, 51–68 years) with 511 axillary lymph nodes were included. On final pathology, 36 (7%) of the lymph nodes had metastasis. A total of 105 original radiomics features were extracted from the T2W MR images. Each cohort split resulted in a different number of lymph nodes in the training cohorts and a different set of selected features. Performance of the 100 clinical and radiomics models showed a wide range of AUC values between 0.41–0.74 and 0.48–0.89 in the training cohorts, respectively, and between 0.30–0.98 and 0.37–0.99 in the validation cohorts, respectively. With these results, it was not possible to obtain a final prediction model. Clinical characteristics and dedicated axillary MRI-based radiomics with node-by-node analysis did not contribute to the prediction of axillary lymph node metastasis in breast cancer based on data where variations in acquisition and reconstruction parameters were not addressed.

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