Predictive Factors Among Clinicopathological Characteristics for Sentinel Lymph Node Metastasis in T1-T2 Breast Cancer

Minami, Shigeki; Sakimura, Chika; Irie, Junji; Tokai, Yukiko; Ōkubo, H.; Ohno, Tsuyoshi

doi:10.2147/cmar.s284922

Cited by 11 publications

(9 citation statements)

References 26 publications

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“…Several previous publications have identified tumor size to be the strongest predictive factor of the risk of SLN positivity 23,24 and to be associated with a higher probability of detection of metastatic disease after ALND; [25][26][27][28][29] our results are consistent with the literature showing that patients with a larger tumor size in final pathology are more likely to be SLNB-positive. With a one-unit increase in tumor size in final pathology, the likelihood of being SLNB-positive increases by 26.4% (OR = 1.264; 95% CI, 1.019-1.568).…”

Section: Discussionsupporting

confidence: 90%

Factors Predicting Positive Sentinel Lymph Node Biopsy in Clinically Node-Negative Breast Cancer

Alsumai¹,

Alhazzaa²,

Al-Shamrani³

et al. 2022

BCTT

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Purpose Sentinel lymph node (SLN) biopsy (SLNB) is the standard tool to stage the axilla of breast cancer patients. This study aimed to identify the predictors of positive SLNB in patients with clinically node-negative breast cancer. Patients and Methods A retrospective, single-institution cohort of patients with early-stage breast cancer without clinically identifiable axillary lymphadenopathy was chosen from January 2010 to December 2018. Logistic regression was used to identify possible predictors of positive SLNB. Results Four hundred and seventy patients were identified; their mean age was 50±11 years. Most patients had the following characteristics: invasive ductal carcinoma (n=382, 81.3%), unilateral tumor (n=461, 98.1%), unifocal disease (n=351, 74.7%), intermediate grade (n=276, 59.0%), and estrogen and progesterone receptor positivity with human epidermal growth factor receptor 2 negativity (n=305, 64.9%). The mean size of the breast mass was 2.3±1.5 cm. SLNB was positive in 128 (27.2%) cases. The mean number of SLNs was 2±1.2. Axillary lymph node dissection was performed in 109 patients. The mean number of lymph nodes removed was 15±6. In 66 (60.6%) of the 109 patients with metastatic axillary nodes, only the SLNs were found to be positive. The number of SLNs, tumor size, tumor grade, receptor status, prominent axillary lymph nodes, and lymphovascular invasion predicted positive SLNB ( P = 0.01, 0.03, 0.03, and 0.04 and <0.001 and <0.001, respectively). Conclusion Our results suggest that a number of histopathological and radiological characteristics of breast cancer can predict SLNB positivity in clinically node-negative breast cancer patients.

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Section: Discussionsupporting

confidence: 90%

Factors Predicting Positive Sentinel Lymph Node Biopsy in Clinically Node-Negative Breast Cancer

Alsumai¹,

Alhazzaa²,

Al-Shamrani³

et al. 2022

BCTT

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“…During the past years, a lot of research has been done on determining the risk factors for lymph node involvement and survival in patients with different subtypes of breast cancer or coexisting with distant metastasis at initial diagnosis [13,[15][16][17][18][19]. As IDC and invasive lobular carcinoma (ILC) accounted for the vast majority of cases, the clinicopathological characteristics of these two types of breast cancer were the main object of intensive research.…”

Section: Discussionmentioning

confidence: 99%

“…First, this is a retrospective cohort study which may inevitably lead to some selected bias. Second, while the sample size of female patients with PMBC in our study was considered proper, yet it remains smaller than several studies on assessing the risk factors of regional LNM or long-term survival in patients with breast cancer [ 13 , 14 , 20 ]. Third, the vast majority of the study race is white (74.99%).…”

Section: Discussionmentioning

confidence: 99%

“…With the popularization of breast mammography and ultrasound, an increasing number of female patients with small primary breast cancer were screened out and clinically diagnosed. Despite the relatively small primary tumor focus (T 1-2 ), defined as a maximum diameter less than or equal to 50 mm, considerable patients still suffered from regional metastasis, bone metastasis, and even visceral metastases at initial diagnosis [ 13 ]. Moreover, only a small number of listed studies are focused on investigating the risk factors for predicting the prognosis in patients with PMBC [ 6 , 7 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Identifying Clinicopathological Risk Factors of the Regional Lymph Node Metastasis in Patients with T1-2 Mucinous Breast Cancer: A Population-Based Study

Min

Wei

Chen

et al. 2021

Journal of Oncology

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Background. Pure mucinous breast cancer (PMBC) has a better prognosis than other types of invasive breast cancer. However, regional lymph node metastasis (LNM) might reverse this outcome. We aim to determine the independent predictive factors for regional LNM and further develop a nomogram model for clinical practice. Method. Data of PMBC patients from the Surveillance, Epidemiology, and End Results (SEER) program between Jan 2010 and Dec 2015 were retrospectively reviewed. Univariate and multivariate logistic regression analyses were used to determine the risk factors for LNM in T1-2 MBC. The nomogram was constructed and further evaluated by an internal validation cohort. The receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration curves were performed to evaluate the accuracy of this model. Result. Five variables, including age, race, tumor size, grade, and breast subtype, were identified to be significantly associated with regional LNM in female patients with T1-2 PMBC. A nomogram was successfully established with a favorable concordance index (C-index) of 0.780, supported by an internal validation cohort with a C-index of 0.767. Conclusion. A nomogram for predicting regional LNM in female patients with T1-2 PMBC was successfully established and validated via an internal cohort. This visualized model would assist surgeons to make appropriate clinical decisions in the management of primary PMBC, especially in terms of whether axillary lymph node dissection (ALND) is warranted.

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“…Bevilacqua et al suggested that the incidence of ALN metastasis is 32.3% when tumor is in central position, higher than tumor of upper-inner-quadrant (20.6%) ( 18 ). Japanese researchers investigated a cohort of 313 cases and found that T1 and T2 breast cancer patients with a tumor located closer to the nipple have a higher risk of sentinel lymph node (SLN) metastases ( 19 ). However, with regard to the effect of tumors located in central and nipple portion (TCNP) in Chinese breast cancer patients, few studies have been reported.…”

Section: Introductionmentioning

confidence: 99%

Real-world outcomes for Chinese breast cancer patients with tumor location of central and nipple portion

Wang

et al. 2022

Front. Surg.

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BackgroundThe association between tumor location and breast cancer prognosis has been controversial. We sought to explore the relationship between tumors located in central and nipple portion (TCNP) and Chinese breast cancer.Patients and methodsA total of 1,427 breast cancer patients were recruited. There were 328 cases of TCNP and 1,099 cases of tumors in the breast peripheral quadrant (TBPQ). The chi-square test was used to compare different variables between TCNP and TBPQ groups. A one-to-one propensity score matching (PSM) was applied to construct a matched sample consisting of pairs of TCNP and TBPQ groups. Kaplan–Meier curves were used for survival analysis of disease-free survival (DFS), breast cancer-specific survival (BCSS) and overall survival (OS). The Cox proportional hazards regression model was applied to identify prognostic risk factors.ResultsThe median follow-up time was 58 months. Compared to TBPQ, TCNP patients had significantly larger tumor size, more frequent metastasis to lymph nodes (LN) and more proportions of TNM stage II–III. DFS, OS and BCSS rates were markedly lower in the TCNP group as compared to the TBPQ group before and after PSM (all p < 0.05). Multivariate Cox analysis showed that TCNP was an independent prognostic factor for breast cancer. Subgroup analysis indicated that for breast molecular subtypes and TNM stage II-III breast cancer, TCNP were related to worse prognosis. Multivariate logistic regression revealed that TCNP was an independent contributing factor for LN metastasis.ConclusionIn Chinese breast cancer, compared to TBPQ, TCNP is associated with more LN metastasis and poorer prognosis.

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Predictive Factors Among Clinicopathological Characteristics for Sentinel Lymph Node Metastasis in T1-T2 Breast Cancer

Cited by 11 publications

References 26 publications

Factors Predicting Positive Sentinel Lymph Node Biopsy in Clinically Node-Negative Breast Cancer

Factors Predicting Positive Sentinel Lymph Node Biopsy in Clinically Node-Negative Breast Cancer

Identifying Clinicopathological Risk Factors of the Regional Lymph Node Metastasis in Patients with T1-2 Mucinous Breast Cancer: A Population-Based Study

Real-world outcomes for Chinese breast cancer patients with tumor location of central and nipple portion

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