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01-07-2014 | Original Article

In breast cancer patients sentinel lymph node metastasis characteristics predict further axillary involvement

Authors: Ildiko Illyes, Anna-Maria Tokes, Attila Kovacs, A. Marcell Szasz, Bela A. Molnar, Istvan A. Molnar, Ilona Kaszas, Zsuzsanna Baranyak, Zsolt Laszlo, Istvan Kenessey, Janina Kulka

Published in: Virchows Archiv | Issue 1/2014

Abstract

The aim of the study was to correlate various primary tumor characteristics with lymph node status, to examine sentinel lymph node (SLN) metastasis size and non-SLN axillary involvement, to look for a cut-off size/number value possibly predicting additional axillary involvement with more accuracy and to examine the relationship of SLN metastasis size to overall survival. Of 301 patients who underwent SLN biopsy, 75 had positive SLNs. The size of the metastases was measured. For different size categories, association with the prevalence of non-SLN metastases was assessed. Associations between metastasis size and tumor characteristics and overall survival (OS) were studied. The prevalence of axillary lymph node (ALN) involvement was not significantly different between cases with micrometastasis or macrometastasis in SLNs (p = 0.124). However, for metastases larger than 6, 7, and 8 mm, the prevalence of ALN involvement was significantly higher (p = 0.046, 0.022, and 0.025). OS was significantly lower in SLN-positive than in SLN-negative cases (p = 0.0375). Primary tumor size larger than 20 mm was associated with a significantly higher incidence of SLN metastasis (p < 0.001), and primary tumor size over 26 mm was associated with additional positive non-SLN (p < 0.001). Higher mitotic index (≥7) in primary tumors was significantly (p < 0.001) associated with ALN involvement in SLN-positive cases, whereas higher Ki67 labeling index was not significantly correlated with SLN or ALN involvement. Lymphovascular invasion (LVI) in primary tumors was significantly correlated with SLN positivity (p < 0.001) but not with further ALN involvement or OS. Tumor size and LVI are predictive for SLN metastasis. Mitotic index, primary tumor size, and larger volume SLN involvement are determinants of further ALN involvement. SLN metastasis size over 6 mm is a strong predictor of further axillary involvement. OS is shorter in the presence of positive SLN.

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Title: In breast cancer patients sentinel lymph node metastasis characteristics predict further axillary involvement
Authors: Ildiko Illyes
Anna-Maria Tokes
Attila Kovacs
A. Marcell Szasz
Bela A. Molnar
Istvan A. Molnar
Ilona Kaszas
Zsuzsanna Baranyak
Zsolt Laszlo
Istvan Kenessey
Janina Kulka
Publication date: 01-07-2014
Publisher: Springer Berlin Heidelberg
Published in: Virchows Archiv / Issue 1/2014
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-014-1579-5

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In breast cancer patients sentinel lymph node metastasis characteristics predict further axillary involvement

Abstract

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Abstract

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