Background- nd Breast cancer is the 2 most common cancer globally and it ranks rst in India. The predictive value of various components like hormone receptor status, tumor size, grade to axillary lymph nodal metastasis has been studied previously. Our aim is to study the correlation of receptor status and axillary lymph nodal metastasis in breast cancer patients. Methods- This is a retrospective study carried out in single surgical unit. 104 biopsy proven unilateral breast cancer patients who underwent modied radical mastectomy has been reviewed. The clinicopathological data has been collected from hospital records. Results- The mean age of presentation is 42.2years. Most common age group is 30-49years with clinical stage III(65.38%) with inltrating ductal carcinoma(99.03%). Although axillary lymph node was palpable in 75%, nodal metastasis is present in 63.46% of patients. Positive estrogen receptor, progesterone receptor and Her2 receptors are seen in 45.19%, 34.6% and 59.61% patients respectively. TNBC patients has least while triple positive has maximum nodal metastasis in our study group. Perineural invasion and extra capsular extension is seen in 15.38% each and lymphovascular invasion is seen in 38.4% patient. Although LVI, PNI and ECE is predominant in Her2-enriched subtypes, most patients belonging to HR+/Her2+ subtypes has LVI, PNI and ECE. TNBC and HR+/Her2- subtypes has least LVI, PNI and ECE. Conclusion- Receptor status has signicant role in predicting nodal metastasis. TNBC, although considered most aggressive, has least axillary nodal metastasis suggesting less lymphatic involvement and less LVI, PNI and ECE. Also Her2 over-expression seems to be related to nodal metastasis, LVI, PNI and ECE, suggesting there may be some pathway which is still unrevealed. Thus Her2 receptor positivity can be considered as an independent poor prognostic factor.

INTRODUCTIONBreast malignancies are the second most common cause of cancer-related mortality among women. As the size of the primary breast cancer increases, some cancer cells are shed into cellular spaces and transported via the lymphatic network of the breast to the regional lymph nodes, especially the axillary lymph nodes. Cancer cells may grow through the lymph node capsule and fix to contiguous structures in the axilla, including the chest wall. Typically, axillary lymph nodes are involved sequentially from the low (level I) to the central (level II) to the apical (level III) lymph node groups. Approximately 95% of the women who die of breast cancer have distant metastases, and traditionally the most important prognostic correlate of disease-free and overall survival was axillary lymph node status. Women with node-negative disease had less than a 30% risk of recurrence, compared with as much as a 75% risk for women with node-positive disease. 1,2The status of axillary lymph node metastasis, in addition to being the most important prognostic factor in this group of patients, has a critical place in the management ABSTRACT Background: Breast malignancies are the second most common cause of cancer-related mortality among women. As the size of the primary breast cancer increases, some cancer cells are shed into cellular spaces and transported via the lymphatic network of the breast to the regional lymph nodes, especially the axillary lymph nodes. Objective of the study was to determine the accuracy of USG and US-FNAC in detecting lymph node metastasis in a clinically lymph node negative CA Breast patient. Methods: This prospective study was conducted on 40 consecutive patients with biopsy proven breast cancer with clinically negative axilla, who had attending the OPD or IPD in our department of surgery, Swaroop Rani Nehru Hospital, Allahabad, during the period of 2014 to 2015. All of these patients were planned to undergo surgery (breast conservation or modified radical mastectomy with axillary clearance). Results: Sensitivity of the study = 97.77%, specificity = 25%, positive predictive value =92.01%, negative predictive value =50%, diagnostic accuracy =90%. Conclusions: Using axillary ultrasound and selective US-FNAC is a rapid, non-morbid method of staging the axilla in newly diagnosed breast cancer patients and should become a routine part of patient care because it can spare many patients particularly those who are undergoing axillary dissection.

No abstract