Predictors of Axillary Lymph Node Metastases (ALNM) in a Korean Population with T1-2 Breast Carcinoma: Triple Negative Breast Cancer has a High Incidence of ALNM Irrespective of the Tumor Size
Predictors of Axillary Lymph Node Metastases (ALNM) in a Korean Population with T1-2 Breast Carcinoma: Triple Negative Breast Cancer has a High Incidence of ALNM Irrespective of the Tumor Size
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DOI：
10.4143/crt.2010.42.1.30
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发表时间：
2010-03-01
影响因子：
4.6
通讯作者：
Kim, Hoon Kyo
中科院分区：
文献类型：
--
作者：
Lee, Jong Hoon;Kim, Sung Hwan;Kim, Hoon Kyo
目的基于多种临床和病理因素，评估乳腺癌患者腋窝淋巴结转移（ALNM）的可能性。材料与方法对361例行保乳手术、腋淋巴结清扫（ALND）（一级和二级）或改良根治性乳房切除术（MRM）的无远处转移的乳腺癌患者进行回顾性分析，回顾其病理记录和治疗资料。结果104例患者腋窝淋巴结阳性，总发生率为28.8%，其中T1a 2例（5%），T1b 5例（9.2%），T1c 24例（21.8%），T2 73例（44.2%）。在多因素分析中，肿瘤体积增大（调整后的OR = 11.87, p = 0.02）、淋巴血管侵犯（调整后的OR = 7.41, p < 0.01）、三阴性（ER/PR-、Her2-）（调整后的OR = 2.09, p = 0.04）和诊断时可触及肿块（调整后的OR = 2.31, p = 0.03）都是ALNM阳性的重要独立因素。结论肿瘤大小、有无淋巴血管侵犯、三阴性和可触及肿块是ALNM的独立预测因素。肿瘤大小是ALNM的最强预测因子。因此，准确估计肿瘤的范围是临床医生优化患者治疗的必要条件。三阴性的患者无论肿瘤大小，ALNM的发病率都很高。
PurposeWe estimated the likelihood of breast cancer patients having axillary lymph node metastases (ALNM) based on a variety of clinical and pathologic factors.Materials and MethodsThree hundred sixty-one breast cancer patients without distant metastases and who underwent breast conserving surgery and axillary lymph node dissection (ALND) (level I and II) or modified radical mastectomy (MRM) were identified, and we retrospectively reviewed their pathology records and treatment charts.ResultsPositive axillary lymph nodes were detected in 104 patients for an overall incidence of 28.8%: 2 patients (5%) with T1a tumor, 5 (9.2%) with T1b tumor, 24 (21.8%) with T1c tumor and 73 (44.2%) with T2 tumor. On the multivariate analysis, an increased tumor size (adjusted OR = 11.87, p = 0.02), the presence of lymphovascular invasion (adjusted OR = 7.41, p < 0.01), a triple negative profile (ER/PR-, Her2-) (adjusted OR = 2.09, p = 0.04) and a palpable mass at the time of diagnosis (adjusted OR = 2.31, p = 0.03) were all significant independent factors for positive ALNM.ConclusionIn our study, the tumor size, the presence of lymphovascular invasion, a triple negative profile and a palpable mass were the independent predictive factors for ALNM. The tumor size was the strongest predictor of ALNM. Thus, the exact estimation of the extent of tumor is necessary for clinicians to optimize the patients' care. Patients with a triple negative profile have a high incidence of ALNM irrespective of the tumor size.