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25-04-2024 | Metastasis | Clinical trial

Characteristics and risk factors of axillary lymph node metastasis of microinvasive breast cancer

Authors: Soo-Young Lee, Tae-Kyung Yoo, Jisun Kim, Il Yong Chung, Beom Seok Ko, Hee Jeong Kim, Jong Won Lee, Byung Ho Son, Sae Byul Lee

Published in: Breast Cancer Research and Treatment

Abstract

Purpose

To select patients who would benefit most from sentinel lymph node biopsy (SLNB) by investigating the characteristics and risk factors of axillary lymph node metastasis (ALNM) in microinvasive breast cancer (MIBC).

Methods

This retrospective study included 1688 patients with MIBC who underwent breast surgery with axillary staging at the Asan Medical Center from 1995 to 2020.

Results

Most patients underwent SLNB alone (83.5%). Seventy (4.1%) patients were node-positive, and the majority had positive lymph nodes < 10 mm, with micro-metastases occurring frequently (n = 37; 55%). Node-positive patients underwent total mastectomy and axillary lymph node dissection (ALND) more than breast-conserving surgery (BCS) and SLNB compared with node-negative patients (p < 0.001). In the multivariate analysis, independent predictors of ALNM included young age [odds ratio (OR) 0.959; 95% confidence interval (CI) 0.927–0.993; p = 0.019], ALND (OR 11.486; 95% CI 5.767–22.877; p < 0.001), number of lymph nodes harvested (≥ 5) (OR 3.184; 95% CI 1.555–6.522; p < 0.001), lymphovascular invasion (OR 6.831; 95% CI 2.386–19.557; p < 0.001), presence of multiple microinvasion foci (OR 2.771; 95% CI 1.329–5.779; p = 0.007), prominent lymph nodes in preoperative imaging (OR 2.675; 95% CI 1.362–5.253; p = 0.004), and hormone receptor positivity (OR 2.491; 95% CI 1.230–5.046; p = 0.011).

Conclusion

Low ALNM rate (4.1%) suggests that routine SLNB for patients with MIBC is unnecessary but can be valuable for patients with specific risk factors. Ongoing trials for omitting SLNB in early breast cancer, and further subanalyses focusing on rare populations with MIBC are necessary.

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Title: Characteristics and risk factors of axillary lymph node metastasis of microinvasive breast cancer
Authors: Soo-Young Lee
Tae-Kyung Yoo
Jisun Kim
Il Yong Chung
Beom Seok Ko
Hee Jeong Kim
Jong Won Lee
Byung Ho Son
Sae Byul Lee
Publication date: 25-04-2024
Publisher: Springer US
Keywords: Metastasis
Breast Cancer
Breast Cancer
Published in: Breast Cancer Research and Treatment
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-024-07305-x

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