Histologic Grade Remains a Prognostic Factor for Breast Cancer Regardless of the Number of Positive Lymph Nodes and Tumor Size: A Study of 161 708 Cases of Breast Cancer From the SEER Program

2014 ◽  
Vol 138 (8) ◽  
pp. 1048-1052 ◽  
Author(s):  
Arnold M. Schwartz ◽  
Donald Earl Henson ◽  
Dechang Chen ◽  
Sivasankari Rajamarthandan
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Nodal Status ◽  
Histologic Grade ◽  
Axillary Lymph Nodes ◽  
Low Grade ◽  
Axillary Lymph ◽  
Data Set

Context.—The appropriate staging of breast cancers includes an evaluation of tumor size and nodal status. Histologic grade in breast cancer, though important and assessed for all tumors, is not integrated within tumor staging. Objective.—To determine whether the histologic grade remains a prognostic factor for breast cancer regardless of tumor size and the number of involved axillary lymph nodes. Design.—By using a new clustering algorithm, the 10-year survival for every combination of T, N, and the histologic grade was determined for cases of breast cancer obtained from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. There were 36 combinations of TN, defined according to the American Joint Committee on Cancer, and grade. Results.—For each combination of T and N, a categorical increase in the histologic grade was associated with a progressive decrease in 10-year survival regardless of the number of involved axillary lymph nodes or size of the primary tumor. Absolute survival differences between high and low grade persisted despite larger tumor sizes and greater nodal involvement, though trends were apparent with increasing breast cancer stage. Statistical significance depended on the number of cases for each combination. Conclusions.—Histologic grade continues to be of prognostic importance for overall survival despite tumor size and nodal status. Furthermore, these results seem to indicate that the assignment of the histologic grade has been consistent among pathologists when evaluated in a large data set of patients with breast cancer. The incorporation of histologic grade in TNM staging for breast cancer provides important prognostic information.

scholarly journals Bone Metastasis Prognostic Factors in Breast Cancer

2019 ◽  
Vol 13 ◽  
pp. 117822341983097 ◽  
Author(s):  
Akram Yazdani ◽  
Sara Dorri ◽  
Alireza Atashi ◽  
Hoda Shirafkan ◽  
Hedieh Zabolinezhad
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Bone Metastasis ◽  
Lymph Nodes ◽  
Bone Metastases ◽  
Tumor Size ◽  
Menopausal Status ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Factors Associated

Objective: Bone is the most common site of metastasis in breast cancer. Prognostic factors for predicting bone metastases in breast cancer are controversial yet. In this study, we investigated clinical factors associated with secondary bone metastasis of breast cancer. Methods: In total, 1690 patients with breast cancer recorded between 2002 and 2012 in Motamed Cancer Institute, Tehran, Iran entered in the retrospective study. We studied age, menopausal status, histologic type, tumor size, number of cancerous axillary lymph nodes, serum concentrations of alkaline phosphatase (ALP), carcinogenicity antigen (CEA), cancer antigen (CA)-153, and hemoglobin (HB) in 2 groups with bone metastases (n = 123) and without it, respectively. We applied logistic regression to identify bone metastasis prognostic factors in breast cancer patients and calculated the cut-off value, sensitivity, and characteristics of independent prognostic factors using receiver operating characteristic (ROC) curve analysis. Results: Menopause, larger tumor size, and the greater number of cancerous axillary lymph nodes increased the chance of bone metastases significantly ( P < .05). There was no significant difference between mean groups with and without bone metastases regarding serum concentration of CEA, CA-153, HB, and histopathologic type ( P > .05). Logistic regression showed that age (odds ratio (OR) = 1.021), menopausal status (OR = 1.854), number of cancerous axillary lymph nodes (OR = 1.065), a tumor size between 2 and 5 cm diameter (OR = 2.002) and more than 5 cm diameter (OR = 4.009), and ALP (OR = 1.005) are independent prognostic factors associated with bone metastases. The ROC curve showed that the abovementioned factors have comparable predictive accuracy for bone metastases. Conclusions: Age, menopausal status, number of axillary lymph node metastases, tumor size, and ALP were identified as prognostic factors for bone metastasis in patients with breast cancer. So patients with these characteristics should be monitored more precisely with regular follow-ups.

scholarly journals Histopathological analysis and surgical treatment of breast cancer - our experience

2016 ◽  
Vol 69 (1-2) ◽  
pp. 59-64
Author(s):  
Dzemail Detanac ◽  
Dzenana Detanac ◽  
Avdo Ceranic ◽  
Merima Ceranic
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
General Hospital ◽  
Tumor Size ◽  
Significant Positive Correlation ◽  
Disease Stage ◽  
Axillary Lymph Nodes ◽  
Histopathological Analysis ◽  
Axillary Lymph ◽  
Positive Correlation

Introduction. The aim of this study was to show the descriptive and histopathological analysis and applied surgical technique with early and late postoperative complications in patients with breast cancer who were hospitalized and treated at the General Hospital in Novi Pazar during the period 2009-2011. Material and Methods. During the period from 2009 to 2011, 59 patients were operated for breast cancer at the General Hospital in Novi Pazar. The study included the size and type of the tumor, disease stage, surgical techniques and complications, the age of the patients at the moment of surgery and its correlation with the number of metastatic lymph nodes in the axilla and the tumor size, as well as the correlation of the tumor size with the number of metastases in the axillary lymph nodes. Results. The difference in the tumor size in relation to the age among the women under 50 and over 50 years of age was not statistically significant (T = -1.203, p>0.05). There was no statistically significant difference between the number of positive lymph nodes in the women under and over 50 years of age (Mann-Whitney U test, p>0.05). A significant positive correlation between the tumor size and the number of positive axillary lymph nodes was found (r= 0.308, p<0.05). A significant positive correlation of the patient?s age and breast cancer stage was also confirmed with nonparametric variance analysis by Spearman?s Rho (r= 0.337, p<0.05). Conclusion. The majority of women from this study sample were with Stage II of breast cancer, which points out the necessity for better prevention and education of women in order to improve early diagnosis of breast cancer. The number of positive axillary lymph nodes appears to be an important prognostic factor and a significant positive correlation between the tumor size and the number of positive axillary lymph nodes has been found.

Axillary Ultrasound as Preoperative Staging in Clinical Negative Axillary Lymph Node Breast Cancer Patient

2021 ◽  
Vol 15 (5) ◽  
pp. 1222-1224
Author(s):  
M. S. Javid ◽  
M. Barry
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Preoperative Staging ◽  
Nodal Status ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Nodal Disease ◽  
Axillary Ultrasound

Objective: To determine the diagnostic accuracy of axillary US as a preoperative investigation by comparing it with the histology outcome of nodal status. Methods: This validation analysis was conducted in Mater Misericordia university hospital, Dublin Ireland form Feb 2007 to Feb 2015. All female patients with impalpable axillary lymph node and histology proven unifocal breast cancer between ages 18 to 75 years were included. Patients with the diagnosis of breast cancer were followed with Ultrasound imaging and results in Picture Archiving and communication system (PACS) and histology was confirmed using the patient center data base in both preoperative and postoperative course of breast cancer, including both sentinel lymph nodes and axillary lymph nodes. Results: A total of 625 patients had axillary ultrasound (US) to assess the preoperative axillary nodal status with mean age of 56±12 years. cN0 was diagnosed in 469 (75%) cases, cN1 in 136 (21.8%) cases and cN2 in 20 (3.2%) cases. After negative axillary ultrasound cN0 pathology shows positive pN2 and pN3 disease in 14 (2.9%) cases with the NPV of 97.01%. Axillary ultrasound had shown cN1 disease in 136 cases with the pathology outcome of pN2 and pN3 in 41 (30.14%) cases with the negative predictive value (NPV) of 69.85%. The overall sensitivity and specificity of the axillary US in detection of the positive node was 51.6% and 92.8% with PPV of 82.69% and NPV of 74.2%. Conclusion: Axillary US is a useful modality for screening of breast cancer patients. The negative US findings exclude the presence of advanced nodal disease. However, it cannot accurate distinguish between pN1 and pN2 or pN3 nodal disease. Keywords: Axillary ultrasound, Axillary lymph nodes, Breast cancer.

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