Implication of Extracapsular Invasion of Sentinel Lymph Nodes in Breast Cancer: Prediction of Nonsentinel Lymph Node Metastasis

Fujii, Takaaki; Yanagita, Yasuhiro; Fujisawa, Tomomi; Hirakata, Tomoko; Iijima, Misa; Kuwano, Hiroyuki

doi:10.1007/s00268-009-0389-4

Cited by 35 publications

(26 citation statements)

References 49 publications

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“…Capsular invasion at metastatic nodes in breast cancer was shown to be strongly associated with further regional nodes metastasis [37,38]. Thus, such a possible increased risk may be related to breast cancer progression, specifically in later stages of the disease.…”

Section: Discussionmentioning

confidence: 99%

Bax promoter G(－248)A polymorphism in a Turkish clinical breast cancer patients: A case-control study

Yildiz¹,

Yaylım²,

Ozkan³

et al. 2013

AJMB

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Bax is an important protein involved in apoptotic process. Mutations of the Bax gene are known to affect protein expression and function. A promotor polymorphism G(−248)A in the 5' UTR of Bax gene may alter regulation of apoptosis in carcinogenesis. Our study was performed to test the association between G(−248)A polymorphisms in the Bax gene and breast cancer risk and progression. G(−248)A polymorphism was genotyped in a Turkish breast cancer, case-control population including 53 female cancer patients (mean age ± SD: 60.9 ± 11.9 years) and 82 controls (mean age ± SD: 57.2 ± 17.5 years) using PCR-RFLP analysis. Genotype and allele frequencies were assessed with the chi-square test. There was no difference in the distribution of Bax genotypes, and allele frequencies were G (87.7% versus 88.4%) and A (12.3% versus 11.6%) in the cancer patients and controls, respectively. Within the cancer group, the presence of a polymorphic Bax G(−248)A allele was not associated with clinico-pathological parameters such as advanced tumor stage, lymph node or distant metastasis. We present the first to report on Bax G(−248)A polymorphisms in breast cancer. Our results suggest that Bax G(−248)A polymorphism do not modify individual susceptibility to invasive breast cancer in Turkish women.

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Section: Discussionmentioning

confidence: 99%

Bax promoter G(－248)A polymorphism in a Turkish clinical breast cancer patients: A case-control study

Yildiz¹,

Yaylım²,

Ozkan³

et al. 2013

AJMB

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“…The disease stage at diagnosis is widely recognized as one of the most important prognostic factors in patients with breast cancer. Traditionally, the pathological determination of tumor size and lymph node status have guided prognosis and adjuvant therapy recommendations for patients with breast cancer (1)(2)(3). Several biomarkers, including endocrine hormone receptor status and human epidermal growth factor receptor 2 (HER2) status, have recently been added to risk evaluation and therapeutic assessment (4,5).…”

Section: Introductionmentioning

confidence: 99%

Implication of duration of clinical presentation on tumor progression and short-term recurrence in patients with early breast cancer

Fujii

Yajima

Morita

et al. 2015

Molecular and Clinical Oncology

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Abstract. Breast cancer growth is dependent on time and it may be of utmost importance to take into consideration the duration of clinical symptoms in order to predict which patients are at high risk for disease recurrence. The aim of this study was to determine the association between duration of clinical symptoms and disease recurrence in patients with breast cancer. A total of 139 consecutive patients with primary breast cancer who underwent a radical breast operation were retrospectively investigated and the association between recurrence and the duration of symptoms was investigated. The duration of clinical signs was defined as the time from the onset of symptoms to the date of surgery. The breast cancer cases were divided into two groups on the basis of symptom duration (≤6 and >6 months). The mean duration of symptoms was 191.0±242.6 days. Of the 139 cases, 36 (25.9%) had a duration of symptoms of >6 months. In the univariate analysis, a statistically significant association with long symptom duration was observed for disease recurrence. Of the 139 patients, 6 (4.3%) developed recurrent disease. The univariate analysis revealed that long duration of symptoms and nuclear grade were significantly associated with recurrence. In conclusion, our results indicated that breast cancer progression is dependent on time. A long duration of symptoms (>6 months) may be considered as an indicator of tumor progression and a strong prognostic factor in breast cancer patients. IntroductionAn accurate determination of poor prognostic factors for breast cancer patients may help guide the selection of more aggressive adjuvant treatment protocols. The disease stage at diagnosis is widely recognized as one of the most important prognostic factors in patients with breast cancer. Traditionally, the pathological determination of tumor size and lymph node status have guided prognosis and adjuvant therapy recommendations for patients with breast cancer (1-3). Several biomarkers, including endocrine hormone receptor status and human epidermal growth factor receptor 2 (HER2) status, have recently been added to risk evaluation and therapeutic assessment (4,5). However, these assessments are useful for the determination of the disease status at diagnosis or at treatment initiation. Breast cancer is a heterogeneous disease and its natural history exhibits significant variability (4,6). Breast cancer growth is dependent on time; however, certain cancers grow rapidly, whereas others develop slowly. The duration of symptoms is not currently incorporated into the internationally recognized staging systems. However, it may be of utmost importance to take into consideration the duration of clinical symptoms in order to identify patients at high risk for disease recurrence. The majority of patients with breast cancer are detected after the onset of symptoms, rather than through screening (7,8). The effect of the duration of the interval between symptom onset and treatment initiation on progression and survival remains uncertain and cannot be ...

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“…12−14 In our previous study, the presence of an ECI at SLNs was found to be a strong predictor of residual axillary disease, or NSLN metastasis. 15 Thus, this study was undertaken to evaluate the presence of ECI in positive SLNs as a predictor of disease recurrence in breast cancer. The key observations made in this study can be summarized as follows: In our metastatic SLN cases, the number of positive lymph nodes and primary tumor size were significantly associated with the recurrence, but the presence of an ECI at SLNs was not a predictor of recurrent disease.…”

Section: Discussionmentioning

confidence: 99%

“…17,18 ECI was defined as extra capsular growth of tumor cells, invasion of perinodal fat or extranodal location of tumor cells. 15 Fisher's exact test, the χ 2 test, and Student's t test were used to compare recurrent and nonrecurrent groups. Multivariate analysis was performed with logistic regression analysis to select covariates.…”

Section: Methodsmentioning

confidence: 99%

“…12−14 We have previously reported that the presence of an ECI at sentinel lymph nodes (SLNs) is a strong predictor of residual axillary disease, or nonsentinel lymph node (NSLN) metastasis in breast cancer. 15 However, it remains to be determined whether ECI at SLNS, not axillary metastatic lymph nodes, is correlated with disease recurrence in breast cancer. The purpose of this study was to evaluate the presence of ECI in positive SLNs as a predictor of disease recurrence in breast cancer.…”

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confidence: 99%

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Extracapsular Invasion of Sentinel Lymph Nodes Is Not Associated With Disease Recurrence in Breast Cancer

Fujii

Yajima

Yamaguchi

et al. 2014

International Surgery

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The purpose of this study was to evaluate the presence of extracapsular invasion (ECI) in positive sentinel lymph nodes (SLNs) as a predictor of disease recurrence in breast cancer. SLN biopsy was performed on 318 breasts of 316 breast cancer patients, of which 50 (15.7%) had positive SLNs. Six (12.0%) of these 50 cases had disease recurrence. The clinicopathologic features of these cases were reviewed. The ECI at SLNs was not significantly associated with disease recurrence. The recurrence-free interval by Kaplan-Meier curves did not differ significantly among patients with and without ECI at SLNs. On the other hand, metastasis at non-SLNs was observed in 12 cases (24.0%) among the 50 cases with positive SLNs, and in the non-SLN metastasis group there were 7 patients with ECI at non-SLNs. Three of 7 cases with ECI at non-SLNs had disease recurrence and none of those 5 without ECI at non-SLNs had disease recurrence. Our current study suggests that the presence of ECI at metastatic SLNs is not associated with recurrent disease in breast cancer. Our results also imply that patients with ECI at positive non-SLNs have a high risk of disease recurrence.

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Implication of Extracapsular Invasion of Sentinel Lymph Nodes in Breast Cancer: Prediction of Nonsentinel Lymph Node Metastasis

Abstract: Our results suggest that the presence of ECI at metastatic SLNs is a strong predictor for residual disease in the axilla. These findings imply the possibility that ALND might be foregone in the treatment of patients with breast cancer without ECI at metastatic SLNs.

Cited by 35 publications

References 49 publications

Bax promoter G(－248)A polymorphism in a Turkish clinical breast cancer patients: A case-control study

Bax promoter G(－248)A polymorphism in a Turkish clinical breast cancer patients: A case-control study

Implication of duration of clinical presentation on tumor progression and short-term recurrence in patients with early breast cancer

Extracapsular Invasion of Sentinel Lymph Nodes Is Not Associated With Disease Recurrence in Breast Cancer

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