Significance of lymphatic invasion combined with size of primary tumor for predicting sentinel lymph node metastasis in patients with breast cancer.
Significance of lymphatic invasion combined with size of primary tumor for predicting sentinel lymph node metastasis in patients with breast cancer.
复制标题
DOI：
--
复制
发表时间：
2015-06
影响因子：
2
通讯作者：
T. Fujii;R. Yajima;Hironori Tatsuki;Toshinaga Suto;Hiroki Morita;S. Tsutsumi;H. Kuwano
中科院分区：
文献类型：
--
作者：
T. Fujii;R. Yajima;Hironori Tatsuki;Toshinaga Suto;Hiroki Morita;S. Tsutsumi;H. Kuwano
背景/目的乳腺癌细胞对淋巴结的选择性亲和力可能主要反映其淋巴道浸润能力。我们进行了本研究，以调查是否存在淋巴浸润的前哨淋巴结（SLN）转移的预测临床淋巴结阴性乳腺癌。患者和方法我们回顾性评估了连续202例临床淋巴结阴性原发性乳腺癌女性患者的病例，这些患者接受了根治性乳腺手术并进行了前哨淋巴结活检。我们研究了SLN转移与临床病理因素（包括淋巴管浸润）的关系。结果202例患者中49例（24.3%）有前哨淋巴结转移。单因素和多因素分析显示，肿瘤大小和淋巴结转移是SLN转移的独立危险因素。在96例淋巴结阴性且肿瘤大小小于20 mm的患者中，仅5例（5.2%）在SLN内有1-2个转移。在34例Ly-C阴性且肿瘤大小小于10 mm的患者中，无SLN转移患者。结论淋巴结侵犯和原发癌的大小是临床淋巴结阴性乳腺癌SLN转移的重要危险因素，肿瘤直径小于20 mm和临床淋巴结阴性乳腺癌患者SLN活检后可避免腋窝淋巴结清扫。对于淋巴结阴性且肿瘤大小小于10 mm的临床淋巴结阴性乳腺癌患者，SLN活检也可能是不必要的。
BACKGROUND/AIM Lymphatic invasion (ly) may mainly reflect the selective affinity of breast cancer cells for lymph nodes. We conducted the present study to investigate whether the presence of lymphatic invasion is a predictor of sentinel lymph node (SLN) metastasis in clinically node-negative breast cancer. PATIENTS AND METHODS We retrospectively evaluated the cases of 202 consecutive female patients with clinically node-negative primary breast cancer who underwent a radical breast operation with SLN biopsy. We examined the relationship between SLN metastasis and the significance of clinicopathological factors, including lymphatic invasion. RESULTS Among the 202 patients, 49 (24.3%) had SLN metastasis. The univariate and multivariate analyses revealed that the size of the tumor and lymphatic invasion were independent risk factors for SLN metastasis. Among the 96 patients who were ly-negative and had a tumor size of less than 20 mm, only 5 (5.2%) had 1-2 metastases within the SLN. Among the 34 patients who were ly-negative and had a tumor size of less than 10 mm, there were no patients with SLN metastasis. CONCLUSION Our results suggest that the presence of lymphatic invasion combined with the size of the primary cancer could be considered a strong risk factor for SLN metastasis in clinically node-negative breast cancer, and patients with a tumor size of less than 20 mm and clinically node-negative breast cancer may avoid axillary lymph node dissection after SLN biopsy. There is also a possibility that SLN biopsy could be unnecessary for patients with clinically node-negative breast cancer who are ly-negative and have a tumor size of less than 10 mm.