scholarly journals Impact of size of the tumor, persistence of estrogen receptors, progesterone receptors, HER2neu receptors and Ki67 values on positivity of axillar lymph nodes at patients with early breast cancer with clinically negative axillar examination

2017 ◽  
Vol 5 (7) ◽  
pp. 825-830
Author(s):  
Borislav Kondov ◽  
Rosalinda Isijanovska ◽  
Zvonko Milenkovikj ◽  
Gordana Petrusevska ◽  
Marija Jovanovski-Srceva ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Lymph Nodes ◽  
Estrogen Receptors ◽  
Early Breast Cancer ◽  
Treated Patient ◽  
Progesterone Receptors ◽  
Microscopic Analysis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph

Aim: The aim of the study was to identify factors that influence the positivity on axillar status at patients with early breast cancer with clinical negative axilla, at which were done radical surgery to breast but also radical lymphadenectomy of axillar lymph nodes.Material and methods: In the study were included 81 surgically treated patients with early breast cancer during 08-2015 to 05-2017 year. All the cases have been analyzed by standard histological analysis including macroscopic and microscopic analysis on standard H&E staining. For determining of molecular receptors immunostaining by PT LINK immunoperoxidase has been done for HER2neu, ER, PR, p53 and Ki67.   Results: Patients age ranged between 31-73 years, average of 56.86 years. The mean size of the primary tumor in the surgically treated patient was 20.33 + 6.0 mm. On dissection from the axilary pits there were taken out 5 to 32 lymph nodes, an average of 14. Metastases have been found in 1 to 7 lymph nodes, an average 0.7. In only 26 (32.1%) of the patients have been found metastases in the axillary lymph nodes. The univariant regression analysis showed that the size of tumor and presence of HER2 neu receptors on cancer cell influence on the positivity of the axillary lymph nodes. The presence of the estrogen receptors, progesterone receptors  showed that they do not have influence on the positivity for metastatic deposits in axillary lymph nodes. Multivariant model and logistic regression analysis as independent significant factors or predictors of positivity of the axillary lymph nodes is influenced from the tumor size only.Conclusion: Our study showed that the involving of the axillary lymph nodes is mainly influenced from the size of the tumor and presence of HER2neu receptors  in the univariant analysis points the important influence of positivity in the axillary lymph nodes but only size of the tumor in multivariate regressive analysis.

scholarly journals Prognostic Factors on the Positivity for Metastases of the Axillary Lymph Nodes from Primary Breast Cancer

PRILOZI ◽  
2017 ◽  
Vol 38 (1) ◽  
pp. 81-90
Author(s):  
Borislav Kondov ◽  
Goran Kondov ◽  
Zoran Spirovski ◽  
Zvonko Milenkovikj ◽  
Risto Colanceski ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Lymph Nodes ◽  
Primary Breast Cancer ◽  
Lymphovascular Invasion ◽  
Treated Patient ◽  
Univariate Analysis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
The Impact

Abstract Aim: The aim of the study was to identify the impact of T stage, the presence of estrogen, progesterone, HER2neu receptors and the values of the Ki67 on the positivity for metastases of the axillary lymph nodes, from primary breast cancer. Material and methods: 290 surgically treated patients for breast cancer were included in the study. All cases have been analyzed by standard histological analysis including microscopic analysis on standard H&E staining. For determining the molecular receptors - HER2neu, ER, PR, p53 and Ki67, immunostaining by PT LINK immunoperoxidase has been done. Results: Patients age was ranged between 18-90 years, average of 57.6+11.9. The mean size of the primary tumor in the surgically treated patient was 30.27 + 18.3 mm. On dissection from the axillary pits 8 to 39 lymph nodes were taken out, an average of 13.81+5.56. Metastases have been found in 1 to 23 lymph nodes, an average 3.14+4.71. In 59% of the patients there have been found metastases in the axillary lymph nodes. The univariate regression analysis showed that the location, size of tumor, differentiation of the tumor, stage, the value of the Ki67 and presence of lymphovascular invasion influence on the positivity of the axillary lymph nodes. The presence of the estrogen receptors, progesterone receptors and HER2neu receptors showed that they do not have influence on the positivity for metastatic deposits in axillary lymph nodes. The multivariate model and the logistic regression analysis as independent significant factors or predictors of positivity of the axillary lymph nodes are influenced by the tumor size and the positive lymphovascular invasion. Conclusion: Our study showed that the involving of the axillary lymph nodes is mainly influenced by the size of the tumor and the presence of lymphovascular invasion in the tumor. Ki67 determined proliferative index in the univariate analysis points the important influence of positivity in the axillary lymph nodes, but not in the multivariate regressive analysis.

Minimal Sentinel Node Procedure for Staging Early Breast Cancer

2002 ◽  
Vol 88 (3) ◽  
pp. S45-S47 ◽  
Author(s):  
S Mariotti ◽  
O Buonomo ◽  
F Guadagni ◽  
A Spila ◽  
S Schiaroli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Regional Anesthesia ◽  
Early Breast Cancer ◽  
Frozen Section ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Sentinel Node Procedure ◽  
Time Saving ◽  
Identification Rate

Aims and Background Sentinel lymph node dissection (SLND) has recently been evaluated as a new staging technique for early breast cancer. To minimize the extent of surgery, the feasibility of eradicating primary breast lesions and the relative sentinel lymph nodes (SLN) under regional anesthesia was evaluated in this study. Methods and Study Design A selected population of 76 patients with suspected operable breast cancer and no clinically palpable lymph nodes was enrolled in the study. Intra- and perilesional administration of a radiotracer was performed. Lymphoscintigraphy was carried out to confirm the drainage pathway and locate the SLN. The following day, after inducing a nervous block induction of the ipsilateral intercostal nerves, we performed the surgical procedure with the help of a hand-held gamma-detecting probe. In case the primary lesion was diagnosed as invasive carcinoma by frozen section, the SLN and the remaining axillary lymph nodes (non-SLNs) were removed. The status of SLN and non-SLNs was compared. Results The primary breast lesion was located and excised in all cases (identification rate: 100%). Lymphoscintigraphy positively identified SLNs in 40/45 (89%) patients; in five patients no lymphatic drainage was detected. In 38 cases an average of 1.5 SLNs and 14 non-SLNs per patient were removed and pathologically analyzed; the remaining two patients showed SLNs in the internal mammary chain, which were not excised. Twenty-nine percent of the patients showed metastatic disease in the lymph nodes examined. Of all patients with affected nodes, 55% had cancer cells only in the SLN. No false negatives (skip metastases) were found. No immediate or long-term anesthesia-related complications (eg pleural lesions, intravascular injection) were observed. Conclusions Our data confirm the feasibility of single radiotracer administration for both occult lesion and SLN localization as well as the usefulness of SLND in staging early breast cancer. Regional anesthesia resulted in easy management and good patient compliance. This time-saving procedure allowed the completion of the whole surgical plan, reducing the recovery time without modifying the effectiveness of surgery.

Patients with preoperatively ultrasonically uninvolved axillary lymph nodes: a distinct subgroup of early breast cancer patients

2005 ◽  
Vol 97 (3) ◽  
pp. 293-299 ◽  
Author(s):  
Janez Zgajnar ◽  
Marko Hocevar ◽  
Maja Podkrajsek ◽  
Kristijana Hertl ◽  
Snjezana Frkovic-Grazio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Distinct Subgroup

Pre-operative assessment of axillary lymph nodes in patients with early breast cancer

2013 ◽  
Vol 39 (5) ◽  
pp. 481
Author(s):  
Anita Maria Huws ◽  
Ifan Patchell ◽  
Saira Khawaja ◽  
Shahzad Khaliq ◽  
Khaldoun Nadi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Early Breast Cancer ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Operative Assessment

scholarly journals Modern view on the issues of diagnosis and verification of axillary lymph nodes involvement in early breast cancer

2020 ◽  
Vol 22 (1) ◽  
pp. 46-52
Author(s):  
Irina V. Kolyadina ◽  
Tatiana Yu. Danzanova ◽  
Svetlana V. Khokhlova ◽  
Oksana P. Trofimova ◽  
Ekaterina V. Kovaleva ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Early Breast Cancer ◽  
Regional Lymph Node ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
High Quality ◽  
Regional Lymph Nodes

The involvement of axillary lymph nodes is one of the most important prognostic factors, significantly affecting the treatment strategy for early breast cancer (BC). The risk of axillary lymph node metastases depends directly on a number of factors (age of women, size of tumor, presence of lymphovascular invasion and biological characteristics of cancer). The evaluation of regional lymph node status in patients with early BC includes the clinical examination of regional zones and the ultrasound study (US), using these methods can help to study lymph nodes shape, borders, margins and structure. The sensitivity of ultrasound in the evaluation of regional lymph nodes status directly depends on the biological subtype of the tumor; the minimum level of ultrasound sensitivity in the evaluation of lymph nodes status is detected for luminal HER2-negative cancer (less than 40%), and maximum sensitivity is detected for triple negative and HER2-positive subtypes (6871%). Clinical examination and modern ultrasound are the most accessible methods for the evaluation of regional lymph nodes status, but the possibility to misjudge metastatic process can be detected in 1/4 of patients. Verification of the diagnosis in the preoperative phase (fine-needle aspiration biopsy/core-needle biopsy under ultrasound guidance) allows minimize the number of errors for the regional staging. The sentinel lymph node biopsy (SLNB) is the gold standard of regional treatment in patients with early stage BC, nowadays. The randomized trials (NSABP B-32, ACOSOG q0011) show the safety of recession of performing regional lymph node dissection in favor of SLNB not only in case of clinically negative lymph nodes, but also in patients with metastases in 2 sentinel lymph nodes, upon condition that organ-conservative treatment and subsequent radiation therapy will be used. High-quality regional staging, the choice of the therapeutic algorithm in accordance with the biological characteristics of carcinoma, the application of the most effective modern drug regimes, the optimal radiation therapy allow not only minimize the extent of surgery, but also achieve high long-term survival results, provide excellent functional results and high quality of life in patients with the involvement of axillary lymph nodes.

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