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

2021 ◽  
Vol 9 (B) ◽  
pp. 679-682
Author(s):  
Dedy Hermansyah ◽  
Gracia Pricilia ◽  
Arjumardi Azrah ◽  
Yolanda Rahayu ◽  
Desiree A. Paramita ◽  
...  

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.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e13060-e13060
Author(s):  
Shusei Tominaga

e13060 Background: The accuracy of the nomogram about non-sentinel lymph node metastasis (NSLNM ) in breast cancer patients is still controversial to avoid axillary dissection particularly sentinel lymph node biopsy was positive. The aim of this study was to evaluate the necessity of adding breast cancer subtypes to the NSLNM nomgram variables. Methods: Between 2009 and 2011, consecutive breast cancer patients without clinically axillary lymph node metastasis (n=140) who received sentinel lymph node biopsy at Higashiosaka General Hospital were studied retrospectively. Twenty-two patients were turned out that breast cancer already spread to the sentinel nodes and all of 22 patients received complete axillary lymph node dissection. Results: Twelve patients had only sentinel lymph node metastases(Group S), 10 patients had non-SLN metastases (Group A). Patient characteristics and average probability of spread to additional lymph node developed by Memorial Sloan-Kettering Cancer Center (MSKCC) Nomogram were almost the same results in both groups. However, subtypes of Group S consisted of 8 HER2 positive , 2 triple negative, and 2 luminal A cases, subtypes of Group A consisted of 4 luminal A and 6 luminal B cases. Conclusions: Our data suggested that luminal type breast cancer tends to spread to non-sentinel lymph node metastasis and adding HER2, Ki-67, and intrinsic biological subtypes may improve predictivity of MSKCC nomogram.


2011 ◽  
Vol 62 (3) ◽  
pp. 209-214 ◽  
Author(s):  
Erin I. Lewis ◽  
Al Ozonoff ◽  
Cheri P. Nguyen ◽  
Michael Kim ◽  
Priscilla J. Slanetz

Background Previous studies of patients with invasive breast cancer examined, with mixed results, tumour location as a predictor of axillary lymph node metastasis. This study assessed whether tumour location in relation to the nipple impacts the presence of axillary lymph node metastasis at the time of diagnosis. Methods A retrospective review was undertaken of the medical records and available imaging of 285 patients diagnosed with invasive breast cancer between January 2001 to June 2007 at Boston University Medical Center. The incidence of axillary lymph node metastasis was correlated with tumour location in relation to the posterior nipple line to control for variation in breast size. Bivariate analysis identified significant variables that were applied to a multiple logistic regression model. Results Axillary lymph node metastasis was not significantly associated with tumour proximity to the nipple. In the multivariate logistic regression analysis, known prognostic factors for axillary metastasis, such as surgical size, lymphovascular invasion, and age of diagnosis, were significant, whereas breast density, palpability, and histologic grade were no longer significant. Conclusions Our study found that there was no evidence that correlates intramammary tumour proximity to the nipple with the presence of axillary lymph node metastasis at diagnosis. However, known prognostic factors, such as lymphovascular invasion, surgical size, and younger age at diagnosis, are strong independent predictors for axillary lymph node involvement.


Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 757
Author(s):  
Sanaz Samiei ◽  
Renée W. Y. Granzier ◽  
Abdalla Ibrahim ◽  
Sergey Primakov ◽  
Marc B. I. Lobbes ◽  
...  

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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