The effect of tumor size and lymph node status on breast carcinoma lethality

Michaelson, James; Silverstein, Melvin J.; Sgroi, Dennis; Cheongsiatmoy, Justin A.; Taghian, Alphonse G.; Powell, Simon N.; Hughes, Kevin S.; Comegno, Arthur; Tanabe, Kenneth K.; Smith, Barbara L.

doi:10.1002/cncr.11765

Cited by 132 publications

(106 citation statements)

References 16 publications

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“…Lymph nodes were identified in all the 22 cases of MRM specimens and were positive for tumor cells in 21 cases. There is 6% additional risk of cancer death by each positive lymph node [14]. 72.73% of our patients were in stage III while as 27.27% were diagnosed to have stage II disease.…”

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confidence: 73%

Clinicopathological Profile of Breast Cancer Patients at a Tertiary Care Hospital in Kashmir Valley

Mir¹,

Manzoor²,

Singh³

et al. 2017

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Introduction: Breast cancer is the commonest malignancy in women worldwide. There are considerable variations in risk factors and presentation of the disease region wise. The present study aimed to describe clinical and pathological profile of breast cancer patients attending tertiary care hospital. Method: All consenting patients attending to surgical out-patient department (OPD) with complaints pertaining to breast disease were enrolled from 16 th June 2015 to 15 th June 2016. The patients were followed and demographic, clinical and pathologic information was recorded and analysed. Results: Total Of 180 patients with breast disease were enrolled. 34/100 were diagnosed of malignancy and formed the cases of the present study. Age of the patients ranged from 22 to 60 years with mean age of 42.06 ± 10.7 years. All the patients presented as breast lump variably associated with pain or discharge. Infiltrating Ductal Carcinoma Not Otherwise Specified (IDC NOS) was common histologic diagnosis (76.47%). Conclusion: Breast carcinoma presents with painless lump and patients are usually diagnosed in our setup at locally advanced stage. Implementation of the simple and effective screening programs for early detection is urgent need in our population.

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confidence: 73%

Clinicopathological Profile of Breast Cancer Patients at a Tertiary Care Hospital in Kashmir Valley

Mir¹,

Manzoor²,

Singh³

et al. 2017

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“…Study done by Michaelson et al revealed that both tumor size and the number of positive lymph nodes make independent contribution to the lethality of invasive breast carcinoma. Lethality increased with increase in the number of positive lymph nodes (Michaelson et al, 2003).…”

Section: Introductionmentioning

confidence: 94%

Impact of Age, Tumor Size, Lymph Node Metastasis, Stage, Receptor Status and Menopausal Status on Overall Survival of Breast Cancer Patients in Pakistan

Mahmood¹,

Faheem²,

Mahmood³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…4,5 These values may be used in the ProbabilityEstimation equation (Equation 7) to estimate the value of the probability of the lethal spread of a cancer cell from a lymph node to the periphery, p node-to-periphery , if we also have information on the size of the cancer in the lymph nodes, N. To provide such information, we measured of the sizes of the cancer deposits in 50 positive lymph nodes from patients with melanoma and in 49 positive lymph nodes from patients with breast carcinoma (Tables 2 and 3). These measurements revealed an average size of the lymph node deposits of 28 mm 2 …”

Section: Spread Of Cancer Cells From a Lymph Node To The Periphery Cmentioning

confidence: 99%

“…4 For both cancers, the overall risk of death is the sum of the risks of death from the lymph nodes and the primary site, which takes the form of a pair of linked equations, the SizeþNodes method. 5 In the current report, we examine the underlying basis for these observations. Underlying the macroscopic features of cancer growth, spread, and lethality (the size of a cancer at the primary site and in the lymph nodes, the number of positive lymph nodes, and the risk of death) lie the microscopic events that affect the fate of cells, such as the spread of cancer cells from 1 location to another.…”

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confidence: 97%

Why cancer at the primary site and in the lymph nodes contributes to the risk of cancer death

Michaelson

Chen

Silverstein

et al. 2009

Cancer

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BACKGROUND:Cancer at both the primary site and in the lymph nodes is associated with lethality, although the mechanism by which lethality arises from each site has been poorly understood. For breast carcinoma, each positive lymph node contributes an approximately 6% risk of death, and each millimeter of primary tumor greatest dimension contributes approximately 1%; whereas, for melanoma, each positive lymph node contributes an approximately 23% risk, and each millimeter of tumor thickness contributes approximately 8%: This is described by a pair of linked equations, the Size+Nodes method.METHODS:A simple expression, the ProbabilityEstimation equation, which was derived from the authors' binary‐biologic model of cancer metastasis, was used to calculate the probabilities of spread of cancer cells from data on tumor size, lymph node status, and death rate.RESULTS:In this report, the authors demonstrated, that when similar masses of cancer are compared, the chance of lethal spread of a cancer cell to the periphery is approximately the same whether the spread emerges from a lymph node or from the primary site. The greater the number of cells at the primary site (tumor size) or the greater the number of cells in the lymph nodes (number of positive lymph nodes), the greater is the aggregate chance that 1 or more cells has undergone a lethal event of spread, a process captured by the Size+Nodes equations.CONCLUSIONS:The lethal contributions of cancer at the primary site and lymph nodes can be explained by a simple mechanical process of the spread of cancer cells occurring with definable probabilities per cell. The presence of cancer in the lymph nodes does not indicate an intrinsic change in a malignancy but, rather, an increased mass of cancer from which spread can emerge. Cancer 2009. © 2009 American Cancer Society.

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The effect of tumor size and lymph node status on breast carcinoma lethality

Cited by 132 publications

References 16 publications

Clinicopathological Profile of Breast Cancer Patients at a Tertiary Care Hospital in Kashmir Valley

Clinicopathological Profile of Breast Cancer Patients at a Tertiary Care Hospital in Kashmir Valley

Impact of Age, Tumor Size, Lymph Node Metastasis, Stage, Receptor Status and Menopausal Status on Overall Survival of Breast Cancer Patients in Pakistan

Why cancer at the primary site and in the lymph nodes contributes to the risk of cancer death

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