Lymph node metastasis and high serum CEA are�important prognostic factors in hormone receptor positive and HER2 negative breast cancer

20 Background: Medullary carcinoma (MC) represents a rare breast cancer subtype associated with a rather favorable prognosis compared with invasive ductal carcinoma (IDC). It is characterized by the high-grade structure and lymphocytic infiltration, hemorrhagic necrosis. The purpose of this study is to compare the clinicopathologic characteristics and outcome of MC to IDC. Methods: We retrospectively reviewed the medical records of patients with invasive breast cancer managed with operation at Samsung Medical Center in Korea from January 1995 to June 2010 except patients diagnosed with ductal carcinoma in situ, patients with distant metastasis at diagnosis or neoadjuvant chemotherapy. 52 cases were identified with MC; 5,716 patients with IDC. The clinicopathologic features, disease-free survival (DFS) and overall survival (OS) for patients with MC were compared with those of the IDC patients. Results: The medullary group presented at younger age (43.9 ± 8.8 vs 47.7 ± 9.9, p=0.006). Also the medullary group was significantly associated with higher histological grade (poor; 80.0 vs 38.3%, p=0.003) and nuclear grade (grade3; 82.8 vs 41.7%, p<0.001) as well as negative ER (84.8 vs 31.0%, p<0.001) and PR status (91.3 vs 38.8%, p<0.001) regarded as poor prognostic factors. But lymphatic invasion was rare (0.0 vs 29.8%, p<0.001) and N stage was low (N0; 86.5 vs 58.4%, p<0.001). The DFS and OS were not significantly different between the medullary and IDC groups. (5-yr DFS : 88.0 vs 89.2 %, p=0.917, 5-yr OS : 94.4 vs 93.4%, p=0.502) In multivariable analysis, factors associated with DFS and OS included nuclear grade, histological grade, tumor size, lymph node metastasis, ER/PR/C-erbB2 status, chemotherapy and hormone therapy. When adjusting for other factors, histological type itself did not show significant difference from IDC in DFS and OS. Conclusions: Despite MC present specific clinicopathologic features, prognosis is not different from IDC and determined by already known prognostic factors such as tumor size, lymph node metastasis. Therefore, the patients with MC also need aggressive treatment like IDC.

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Breast Cancer in Chinese Females Aged 25 Years and Younger

Journal of Oncology ◽

10.1155/2021/4891936 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Lixi Li ◽

Dan Lv ◽

Jingtong Zhai ◽

Di Zhang ◽

Xiuwen Guan ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Cancer Patients ◽

Lymphovascular Invasion ◽

Clinicopathological Characteristics ◽

Breast Cancer Patients ◽

Young Females ◽

Node Metastasis

Background. Breast cancer has both aggressive clinicopathological characteristics and a poor prognosis in young females. However, limited information is available for breast cancer in Chinese females aged ≤25 years. Therefore, we aimed to explore prognostic factors for invasive disease-free (iDFS) and overall survival (OS) among breast cancer patients aged ≤25 years. Methods. We retrospectively analyzed data from 174 Chinese females aged ≤25 years with invasive breast cancer treated in the Cancer Hospital of the Chinese Academy of Medical Sciences from January 1, 1999, to December 31, 2018. Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors. Results. The median follow-up time was 75 months (ranging from 1 to 236 months). Breast cancer patients aged ≤25 years exhibited aggressive clinicopathological characteristics, including advanced tumor stage (21.8%), lymph node metastasis (47.1%), lymphovascular invasion (24.1%), estrogen receptor negativity (44.3%), progesterone receptor (PR) negativity (42.5%), and triple-negative breast cancer (25.3%). Among them, 50 cases had locoregional recurrence and metastasis, 20 had bilateral invasiveness, and 33 had breast cancer-specific deaths. Cox multivariate analysis identified that diagnosis delay, PR status, and radiotherapy were significant prognostic factors for both iDFS and OS ( P < 0.05 ). The risk of recurrence and metastasis was five times higher in N3 than in N0 (HR: 6.778, 95% CI: 2.268–17.141, P < 0.001 ). Patients with lymphovascular invasion had a threefold increase in the risk of breast cancer-specific death (HR: 4.217, 95% CI: 1.956–9.090, P < 0.001 ). No differences were observed between mastectomy and breast-conserving surgery (BCS) plus radiotherapy for iDFS or OS (iDFS: χ2 = 0.678, P = 0.410 ; OS: χ2 = 0.165, P = 0.685 ). Conclusions. Breast cancer in females ≤25 years old was associated with aggressive clinical features and a worse prognosis. Young females with breast lumps should receive timely diagnosis and treatment. Young breast cancer patients with lymphovascular invasion, PR-negative status, and lymph node metastasis have an increased risk of experiencing recurrence and metastasis and should hence be closely monitored. Age at diagnosis should not be the sole deciding factor for surgical treatment methods.

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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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Breast Cancer Close to the Nipple: Does This Increase the Risk of Nodal Metastasis at Diagnosis?

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2010.03.007 ◽

2011 ◽

Vol 62 (3) ◽

pp. 209-214 ◽

Cited By ~ 3

Author(s):

Erin I. Lewis ◽

Al Ozonoff ◽

Cheri P. Nguyen ◽

Michael Kim ◽

Priscilla J. Slanetz

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Axillary Lymph Node ◽

Lymphovascular Invasion ◽

Axillary Lymph Node Metastasis ◽

Axillary Lymph ◽

Node Metastasis ◽

Tumour Location

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.

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393 The prognostic factors of breast cancer related with axillary lymph node metastasis in T1 breast cancer

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(10)70419-5 ◽

2010 ◽

Vol 8 (3) ◽

pp. 171-172

Author(s):

G. Gwak ◽

K. Park ◽

S. Han ◽

K. Kim ◽

H. Kim ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Axillary Lymph Node ◽

Axillary Lymph Node Metastasis ◽

Axillary Lymph ◽

Node Metastasis

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Estrogen Receptors, Progesterone Receptors and their Correlation with respect to HER-2/neu Status, Histological Grade, Size of Lesion, Lymph node Metastasis, Lymphovascular Involvement and Age in Breast Cancer patients in a hospital in north India

Asian Journal of Medical Sciences ◽

10.3126/ajms.v7i3.13563 ◽

2016 ◽

Vol 7 (3) ◽

pp. 28-34 ◽

Cited By ~ 1

Author(s):

Mushood G. Nabi ◽

Andleeb Ahangar ◽

Subiya Kaneez

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Tumor Size ◽

Hormone Receptor ◽

Histological Grade ◽

Low Grade ◽

Inverse Association ◽

Node Metastasis ◽

Her 2

Background: Breast cancer is the second most common cancer overall (1.4 million cases, 10.9%) and ranks 5th as cause of death (458,000. 6.1%).The present study was aimed to find the pattern of expression of ER, PR, HER-2/neu and to correlate ER, PR status with respect to various clinicopathlogical factors like HER-2/neu over expression, histological grade, tumor size, lymphnode metastasis, lymphovascular invasion and age of the patient.Materials and Methods: Data from 139 patients was collected and correlation of ER, PR status with various clinicopathological factors was analysed.Results: Mean age at diagnosis was 48.5 years, 56.8% cases being ?50years of age. Tumor size ranged from 1 to 12 cm. Most lesions (57.5%) were>2 to 5 cm in size. The predominant morphology was Infiltrating Duct carcinoma-NOS (90.6%). Majority of cases presented as grade II(46.7%) lesions and lymph node involvement was seen in 66.9%. 49.6% cases were ER+, 49.6% cases were PR+, and HER-2/neu was positive (3+) in 15.8% cases. Older patients were mostly ER+PR+. Low grade tumors were mostly ER+PR+ as compared to high grade tumors. HER-2/neu status revealed an inverse association with hormone receptor positivity. No correlation was found between hormone receptor positivity and lymph node metastasis. Lymphovascular involvement was noted more in hormone negative ER-PR- tumors.Conclusion: ER and PR expression in our patients was found to be comparable to the studies done in Indian subcontinent, but lower than studies done in west, but triple negative breast cancer prevalence was relatively higher in our study (34.5%).Asian Journal of Medical Sciences Vol. 7(3) 2016 28-34

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Analysis of the prognostic factors of triple-negative breast cancer and the clinical efficacy of postoperative radiotherapy in early cases.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e12502 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e12502-e12502

Author(s):

XT Cheng ◽

Y Zhang ◽

XX Zuo ◽

J Yang ◽

ML Dong ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Adjuvant Chemotherapy ◽

Lymph Node Metastasis ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Postoperative Radiotherapy ◽

Lymphocyte Ratio ◽

Node Metastasis

e12502 Background: To explore the prognostic value of pretherapeutic peripheral blood parameters and breast imaging-reporting and data system (BI-RADS) classification of triple-negative breast cancer (TNBC) and the effect of postoperative radiotherapy in early cases. Methods: A total of 278 TNBC patients’ medical records between January 2013 and December 2018 were retrospectively collected, including white blood cells, neutrophils, lymphocytes, platelets, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), serum tumor markers, BI-RADS classification, TNM staging and therapeutic methods. We used the log-rank test and Kaplan-Meier curves to assess the progression-free survival (PFS) of enrolled patients. Multivariate prognostic analysis was performed by the Cox regression model. Results: The median PFS of all 278 patients was 20 months (4-72 months) at the end of follow-up. Operable patients who obtained adjuvant chemotherapy had a better median PFS (20 vs 18.5 months, P= 0.018, HR = 5.943, 95% CI: 1.36-25.92) than those without. Lymph node metastasis (52%) and chest well relapse (28%) were the critical failure forms followed by other metastases (12% lungs, 9.3% bones, 4% liver and 2.7% brain) with p value less than 0.001. Multivariate analysis indicated that platelet counts > 113.5×109/L (p = 0.024), PLR ≤ 111.7 (p = 0.036) and CA15-3 ≤ 8.4 U/mL (p = 0.003) were significantly associated with the favourable prognosis of PFS in TNBC patients. Furthermore, BI-RADS of grade 2-4 had a better median PFS compared with grade of 5-6(20 vs 17.5 months, p = 0.008, HR = 2.154, 95% CI: 1.219-3.805). In subgroup analysis, forty-three early cases with pN1 stage earned additional benefits from postoperative radiotherapy in terms of low risk of distant metastasis and recurrence (p = 0.014). Residual tumor after surgery was another important factor of poor prognosis (p = 0.029). Conclusions: Adjuvant chemotherapy improved median PFS for operable TNBC patients and pretherapeutic platelets, PLR, CA15-3 and BI-RADS were the independent prognostic factors of survival. Lymph node metastasis and chest well relapse were the main patterns of treatment failure. Radiotherapy could reduce the risk of disease progression for postoperative patients with N1 stage.

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