Clinical Value of Size, quadrant, and Hormonal Status in Predicting Axillary Node Metastasis in Early Clinico-Radiologically Negative Indian Breast Cancer- A Hospital Based Prospective Observational Study

Background: Sentinel lymph node biopsy (SLNB) is standard of care in clinico- radiologically negative axilla in early breast cancer case. It’s an oncologically safe alternative to Axillary lymph node dissection (ALND), however factors predicting sentinel node metastasis in Indian population is lacking. Methods: A prospective observational study which recruited 80 patients with breast cancer who underwent SLNB with or without ALND, with evaluation of predictive factors including size, type and quadrant , hormonal status of breast this characteristics were prospectively analyzed to predict the axillary metastasis and need of SLNB . Result: Mean age of the patients included in our study was 52.4 years. On univariate analysis, size (p<0.013), upper outer quadrant (UOQ) (p<0.038), central quadrant (CQ) (0.07) were significantly associated with axillary node metastasis in T2 tumors. While on multivariate analysis, UOQ (P<0.009), CQ (p<0.02) metastasis were associated with axillary node metastasis in T2 tumors. Overall sensitivity, specificity, positive predictive valve (PPV) and negative predictive valve (NPV) of SLNB in predicting axillary node status was 77.59%, 100%, 100% and 62.86% respectively. The overall accuracy was 83.7%. Conclusion: Upper outer quadrant, central quadrant and size of the tumors are important prognostic factors to predict axillary node metastasis without the need of sentinel node biopsy in early breast cancers.

Ratio of CD68/CD163 in Breast Carcinoma with and without Axillary Lymph Node Metastatic

Tumor and its microenvironment can interact each other. Macrophage is part of tumor microenvironment. New drugs targeting specific superficial receptor of macrophage or cytokine of macrophage polarization have been found. Therefore, macrophage phenotype and its ratio of M1/M2 macrophage need to be identified. This identification could lead us to prognose breast cancer and monitor its therapy. Analytical observational study with cross sectional approach, conducted on paraffin block sample of breast carcinoma from Anatomical Pathology Laboratory of Dr. Soetomo General Hospital. The samples divided into four groups based on nodal metastasis staging (N0, N1, N2, and N3) and stained with antibody against CD68 and CD163. The ratio of CD68 and CD163 were analyzed with Anova test. There were difference expression of CD68 as M1 macrophage marker in various axillary node metastasis groups (p=0.015). There were difference ratio of CD68 as M1 macrophage marker and CD163 as M2 macrophage marker in various axillary node metastasis groups (p=0.005). There were difference ratio of macrophage M1 and macrophage M2 between N0 and N3 group, N2 and N3 group also.

Ratio of CD68/CD163 in Breast Carcinoma with and without Axillary Lymph Node Metastatic

Tumor and its microenvironment can interact each other. Macrophage is part of tumor microenvironment. New drugs targeting specific superficial receptor of macrophage or cytokine of macrophage polarization have been found. Therefore, macrophage phenotype and its ratio of M1/M2 macrophage need to be identified. This identification could lead us to prognose breast cancer and monitor its therapy. Analytical observational study with cross sectional approach, conducted on paraffin block sample of breast carcinoma from Anatomical Pathology Laboratory of Dr. Soetomo General Hospital. The samples divided into four groups based on nodal metastasis staging (N0, N1, N2, and N3) and stained with antibody against CD68 and CD163. The ratio of CD68 and CD163 were analyzed with Anova test. There were difference expression of CD68 as M1 macrophage marker in various axillary node metastasis groups (p=0.015). There were difference ratio of CD68 as M1 macrophage marker and CD163 as M2 macrophage marker in various axillary node metastasis groups (p=0.005). There were difference ratio of macrophage M1 and macrophage M2 between N0 and N3 group, N2 and N3 group also.