The predictors and the prognostic significance of axillary lymph nodes involvement in breast cancer

Abstract

Background: Breast cancer is the most common cancer among women worldwide. The presence of axillary lymph node metastases in breast cancer is an important factor in assessing prognosis and determines management after surgery. The study aimed at identification of the factors that predict axillary lymph node involvement in CA breast. Addressing the prognostic effect of axillary lymph node involvement in turn of predicting the recurrence of CA breast.Methods: This is a prospective review of one hundred cases of Ca breast who have underwent modified radical mastectomy and axillary clearance at Al-Karama Teaching Hospital during the period from January 2014 to December 2018.Results: Positive axillary involvement was found in (74/100, 74%). The highest occurrence of positive axilla was found in (less than 30 and 30-39 years) age groups (27/74, 36%) with the outer quadrants (upper and lower) constituting the majority (50/74, 68%). Positive axillary involvement was mostly notified in tumor grade T4 (39/74, 53%) and in poorly differentiated lesions (47/74, 64%). The highest recurrence rate was found in patients with positive axillary metastases (12/74, 16%), nodal involvement of ten or more nodes (9/41, 22%), nodes with extracapsular extension (10/51, 20%) and in patients who have not taken and/or completed their chemo-radiation sessions (9/11, 82%).Conclusions: Positive axillary lymph node involvement was seen mostly in: young age patients, outer quadrant lesions, tumors with skin involvement, and poorly differentiated lesions.

An <i>In Silico</i> Analysis Identified Members of the Pleckstrin Homology-Like Domain, Family B (PHLDB family) as Potential Prognostic and Predictive Biomarkers of Treatment Response in Breast Cancer Patients

“…It was found that increased expression of the three members of the PHLDB family was significantly correlated with several variables, including lower rates of lymph node involvement and with the lowest degree of SBR and NPI. Routinely in clinical practice, the presence and extent of lymph node metastases are indicators of an aggressive phenotype, generally with an inverse relationship with prognosis (21). Thus, the genes of the PHLDB family, based on this in silico study, are shown to be potential markers for predicting the development of lymph node metastasis and unsatisfactory clinical outcome.…”

In-Silico Analysis of Differentially Expressed Genes and Their Regulating microRNA Involved in Lymph Node Metastasis in Invasive Breast Carcinoma

“…According to the American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) tumor (T)-node (N)metastasis (M) classification, nodal disease is classified in three groups based on the number of axillary metastatic lymph nodes involved: N1, 1-3 metastatic lymph node(s), N2, 4-9 metastatic lymph nodes, and N3, 10 or more metastatic lymph nodes [2]. The prognosis worsens with the increase in the number of metastatic lymph nodes [3,4].…”

“…Positive or negative lymph node metastatic status aid in patient staging, prognostic information, and patient management [6]. Bakkour et al observed that axillary lymph node involvement is significantly associated with overall survival (OS) and disease-free survival (DFS) [4] Studies have also reported that a rise in the number of nodal involvement increases the rate of cancer recurrence [7,8]. Although the involvement of axillary lymph node is the prognostic indicator of BC, the current method used to identify the nodal status, sentinel lymph node biopsy (SLNB), may give false-negative results, disrupt the lymphatic system and may lead to secondary complications.…”

In-silico analysis of differentially expressed genes and their regulating microRNA involved in lymph node metastasis in invasive breast carcinoma

“…According to the American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) tumor (T)-node (N)- metastasis (M) classification, nodal disease is classified in three groups based on the number of axillary metastatic lymph nodes involved: N1, 1–3 metastatic lymph node(s), N2, 4–9 metastatic lymph nodes, and N3, 10 or more metastatic lymph nodes [2]. The prognosis worsens with the increase in the number of metastatic lymph nodes [3, 4]. Five-year survival rates differ dramatically between women with negative lymph nodes (>90%) compared to those with lymph node metastasis (<70%) [5].…”