Clinicopathological Characteristics of Breast Cancers with Axillary Skip Metastases
Clinicopathological Characteristics of Breast Cancers with Axillary Skip Metastases
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DOI：
10.3109/08941939.2011.598605
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发表时间：
2012-01
影响因子：
1.9
通讯作者：
Jing-yan Sun;Jian Yin;L. Ning;Juntian Liu;Hong Liu;L. Gu;L. Fu
中科院分区：
文献类型：
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作者：
Jing-yan Sun;Jian Yin;L. Ning;Juntian Liu;Hong Liu;L. Gu;L. Fu
摘要目的：乳腺癌中存在不连续或“跳跃”转移对于确定最佳治疗选择至关重要。在这项研究中，我们比较了有或没有跳跃转移（SMs）患者的临床病理特征和预后。研究方法：我们回顾性分析了1,502例接受根治性乳房切除术的乳腺癌患者和118例接受前哨淋巴结活检（SLNB）的患者的记录。中位随访时间为10年。结果：1502例患者中814例腋窝淋巴结（ALN）受累，119例（14.6%）患者发现SMs。有或无SM患者的年龄、肿瘤大小、位置、临床分期和胸间淋巴结（IPN）转移的比例相似（p > 0.05）。在I期和II期疾病中，SM患者的无事件生存率显著低于无SM患者（p 0.05）。考克斯多因素分析显示，肿瘤大小、淋巴结转移数目、淋巴结转移和SMs是影响预后的重要因素。SLNB的假阴性率为12.0%（3/25）。结论：腋窝淋巴结SM很难预测，但它们的存在可以预测I和II期患者的预后较差。SLNB阴性者可发生SM。
ABSTRACT Objective: The presence of discontinuous or “skip” metastases in breast cancer is crucial for determining the optimal therapeutic choice. In this study, we compared the clinicopathological characteristics and prognosis of patients with or without skip metastases (SMs). Methods: We retrospectively analyzed the records of 1,502 breast cancer patients who underwent radical mastectomy and a separate group of 118 patients who had sentinel lymph node biopsies (SLNB). The median follow-up time was 10 years. Results: Axillary lymph nodes (ALN) were involved in 814/1502 patients, and SMs was found in 119 patients (14.6%). Age, tumor size, location, clinical stage, and the proportion of interpectoral lymph node (IPN) metastases were similar in patients with or without SMs (p > .05). In stage I and II disease, the event-free survival rate of patients with SMs was significantly lower than patients without (p .05). The Cox multivariate analysis showed that the tumor size, number of lymphatic metastases, lymph node involvement, and SMs were important prognostic factors. The false-negative rate of SLNB was 12.0% (3/25). Conclusion: Axillary lymphatic SM is difficult to predict, but their presence can predict a poorer prognosis for stage I and II patients. SM could occur in SLNB-negative patients.