Axillary lymph node nanometastases are prognostic factors for metastatic relapse in breast cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 610-610
Author(s):  
S. Alberti ◽  
P. Querzoli ◽  
M. Pedriali ◽  
R. Rinaldi ◽  
E. Biganzoli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Adverse Events ◽  
Competing Risks ◽  
Axillary Lymph ◽  
Prognostic Impact ◽  
T Stage ◽  
Metastatic Relapse

610 Background: Early breast cancer presents with a remarkable and largely unaccounted for heterogeneity of outcomes. Undetected, microscopic lymph node tumor deposits may account for a significant fraction of this prognostic diversity. Thus, we systematically evaluated the presence of lymph node tumor cell deposits <0.2 mm in diameter [pN0(i+), nanometastases], and analysed their prognostic impact. Methods: Seven hundred and two single institution, consecutive patients with 8 years of median follow-up were studied. To maximize the chances of detecting micro and nanometastases, whole-axilla dissections were analysed. pN0 cases were systematically reevaluated by step sectioning and anti-cytokeratin immunohistochemical analysis of 6676 corresponding dissected lymph nodes. The risk of first adverse events and of distant relapse of bona fide pN0 patients was compared with that of pN0(i+), pN1mi and pN1 cases. Crude cumulative incidence (CCI) curves were used to estimate the cumulative probability of occurrence of adverse events. CCI curves were compared by the Gray’s test. A proportional sub distribution hazard (SDH) regression model was utilized to assess the difference among CCI curves of pN0(i+) versus pN0(i-), and of pN1mi versus pN0(i+). Competing risks were accounted for and regression models were adjusted for established breast cancer prognostic factors, i.e. grading, pathological T stage and age. Proportional SDH assumptions were checked using Schoenfeld-type residuals. Results: A pN0(i+) status was shown to be a strong risk factor for event-free survival (P<0.0005) and for metastatic relapse in both univariate and multivariate analyses accounting for competing risks and adjusted for grading, pathological T stage and age. Conclusions: Our findings demonstrate that nanometastases are an important risk factor in breast cancer. These results support the inclusion of procedures for nanometastasis detection in TNM pathological staging. No significant financial relationships to disclose.

scholarly journals Axillary Lymph Node Nanometastases Are Prognostic Factors for Disease-Free Survival and Metastatic Relapse in Breast Cancer Patients

2006 ◽  
Vol 12 (22) ◽  
pp. 6696-6701 ◽  
Author(s):  
Patrizia Querzoli ◽  
Massimo Pedriali ◽  
Rosa Rinaldi ◽  
Anna Rita Lombardi ◽  
Elia Biganzoli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Metastatic Relapse ◽  
Disease Free

Simultaneous Immunohistochemical Detection of Tumor Cells in Lymph Nodes and Bone Marrow Aspirates in Breast Cancer and Its Correlation With Other Prognostic Factors

2001 ◽  
Vol 19 (4) ◽  
pp. 960-971 ◽  
Author(s):  
Bernd Gerber ◽  
Annette Krause ◽  
Heiner Müller ◽  
Dagmar Richter ◽  
Toralf Reimer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients

PURPOSE: We studied the prognostic and predictive value of immunohistochemically detected occult tumor cells (OTCs) in lymph nodes and bone marrow aspirates obtained from node-negative breast cancer patients. All were classified as distant metastases-free using conventional staging methods. PATIENTS AND METHODS: A total of 484 patients with pT1-2N0M0 breast cancer and 70 with pT1-2N1M0 breast cancer and a single affected lymph node participated in our trial. Ipsilateral axillary lymph nodes and intraoperatively aspirated bone marrow were examined. All samples were examined for OTCs using monoclonal antibodies to cytokeratins 8, 18, 19. Immunohistological findings were correlated with other prognostic factors. The mean follow-up was 54 ± 24 months. RESULTS: OTCs were detected in 180 (37.2%) of 484 pT1-2N0M0 patients: in the bone marrow of 126 patients (26.0%), in the lymph nodes of 31 patients (6.4%), and in bone marrow and lymph nodes of 23 (4.8%) patients. Of the 70 patients with pT1-2N1MO breast cancer and a single involved lymph node, OTCs were identified in the bone marrow of 26 (37.1%). The ability to detect tumor cells increased with the following tumor features: larger size, poor differentiation, and higher proliferation. Tumors of patients with OTCs more frequently demonstrated lymph node invasion, blood vessel invasion, higher urokinase-type plasminogen activator levels, and increased PAI-1 concentrations. Patients with detected OTCs showed reduced disease-free survival (DFS) and overall survival (OAS) rates that were comparable to those observed in patients who had one positive lymph node. Multivariate analysis of prognostic factors revealed that OTCs, histological grading, and tumor size are significant predictors of DFS; OTCs and grading of OAS. CONCLUSION: OTCs detected by simultaneous immunohistochemical analysis of axillary lymph nodes and bone marrow demonstrate independent metastatic pathways. Although OTCs were significantly more frequent in patients with other unfavorable prognostic factors, they were confirmed as an independent prognostic factor for pT1-2N0M0, R0 breast cancer patients.

Multi-center prospective study on sentinel node navigation surgery in early breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 606-606
Author(s):  
S. Imoto ◽  
M. Kitajima ◽  
T. Aikou ◽  
Y. Kitagawa
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adverse Events ◽  
Prospective Study ◽  
Sentinel Node ◽  
Early Breast Cancer ◽  
Lymphatic Mapping ◽  
Axillary Lymph ◽  
Navigation Surgery ◽  
Sentinel Node Navigation Surgery

606 Background: Sentinel node navigation surgery (SNNS) is a standard technique to identify lymph node metastases in clinically node-negative breast cancer. However, the dye and radiopharmaceuticals for lymphatic mapping commonly used in Western countries are not available in Japan. Methods: To assess the optimal lymphatic mapping and the outcome after SNNS, the Japanese society for SNNS conducted a non-randomized multi-center prospective study on SNNS in early breast cancer. Primary endpoint is to evaluate the success rates and adverse events associated with various lymphatic mapping and SNNS, and secondary endpoint is to observe the outcome of patients who underwent SNNS during 5 years. After the protocol was approved by institutional review board, SNNS had been registered between July 2004 and October 2005. Results: Fourteen hundred and sixty-eight cases had pre-registration from 65 investigators at 23 institutions. As 46 cases were withdrawn for some reasons and 11 cases were diagnosed as benign disease, 1,411 cases were finally entered in this study. Dyes used for lymphatic mapping were indigocarmine, indocyanin green, patent blue, and isosulfun blue, and radiopharmaceuticals were 99m-technetium-labelled tin colloid, human serum albumin, and phytate. In 19 cases, superparamagnetic iron oxide was used for MRI- guided SNNS. As of December 2006, 98% of clinical report forms were analyzed. Dye-guided SNNS was performed in 240 cases, radio-guided SNNS in 56 cases, and combined method in 1,016 cases. Overall success rate was 99%. SNNS alone was treated in 1,138 cases (82%) and SNNS followed by axillary lymph node dissection in 258 cases (12%). Breast-conserving surgery was undergone in 1,175 cases (85%) and total mastectomy in 217 cases (15%). Dye-induced allergic adverse events were not reported. Postoperative adverse events of bleeding, wound infection and seroma were observed in about 1 % of cases, respectively. Conclusions: Dye-guided and/or radio-guided SNNS proved reliable for lymphatic mapping in breast cancer. The prognosis of all cases will be observed until 2010. No significant financial relationships to disclose.

Correlation between Age and Prognostic Factors in Thai Breast Cancer Women: A Single Institute Analysis

2021 ◽  
Vol 104 (7) ◽  
pp. 1153-1158
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Axillary Lymph Node ◽  
Axillary Lymph Node Metastasis ◽  
Her2 Overexpression ◽  
Axillary Lymph ◽  
Large Tumor ◽  
Node Metastasis ◽  
Poorly Differentiated

Background: Breast cancer is the most common cancer in females, especially for those in their middle age between 40 to 60 years. There are prognostic factors of breast cancer such as an intrinsic subtype called triple-negative breast cancer (TNBC), HER2 overexpression, poorly differentiated, large tumor size, axillary lymph node status, and staging. Age at diagnosis is usually associated with aggressive cancer and poorer outcomes. Objective: To explore the age and prognostic factors for breast cancer in Thailand. Materials and Methods: The data were collected from pathological data collection and medical records of Buddhasothorn Hospital, Chachoengsao, Thailand, between 2015 and 2018. All data were collected for studying the relationship between age at diagnosis and prognostic factors. Results: Three hundred three cases were collected. It was found that the age between 35 to 69 years had breast cancer the most (83.83%). The intrinsic subtypes found were Hormonal receptor-positive (HR+) 67.33%, TNBC 22.11%, and HER2 overexpression 10.56%. Age under 35 years had a risk of poor prognostic factors such as poorly differentiated (OR 1.528, 95% CI 0.306 to 7.627, p=0.605), large tumor size greater than 5 cm (OR 2.145, 95% CI 0.560 to 8.221, p=0.266), and axillary lymph node metastasis (OR 1.409, 95% CI 0.345 to 5.762, p=0.633). Age of 70 years and over had more favorable prognostic factors such as well-differentiated (OR 1.691, 95% CI 0.645 to 4.436, p=0.286), no axillary lymph node metastasis (OR 1.734, 95% CI 0.886 to 3.393, p=0.108), and the HR+ subtype (OR 2.158, 95% CI 0.954 to 4.882, p=0.065). Nonetheless, the present study data did show statistical significance. Conclusion: The evidence of breast cancer in Thailand found that the different age ranges affected the prognostic factors differently. Specifically, young age breast cancer had a higher risk of poor prognostic factors, whereas the elderly breast cancer was associated with more favorable prognostic factors. However, a larger number of patient data to the confirm relationship between age and prognostic factors is required. Keywords: Breast cancer; Age-related; Prognostic factors

Risk Factor for Axillary Lymph Node Metastases in Microinvasive Breast Cancer

2011 ◽  
Vol 19 (1) ◽  
pp. 212-216 ◽  
Author(s):  
Beom Seok Ko ◽  
Woo Sung Lim ◽  
Hee Jeong Kim ◽  
Jong Han Yu ◽  
Jong Won Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Axillary Lymph Node Metastases ◽  
Node Metastases ◽  
Microinvasive Breast Cancer
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