Role of clinical and morphological data in prediction of regional lymph node involvement in early-stage breast cancer
https://doi.org/10.17650/1994-4098-2019-15-1-29-34
Abstract
Objective: to evaluate the frequency of axillary lymph node metastasis (detected at routine pathomorphological examination) in order to determine the group of patients who do not require lymph node surgery.
Materials and methods. We analyzed medical records of 485 patients with breast cancer and no signs (either clinical or instrumental) of regional lymph node involvement who underwent surgery at the first stage of their treatment.
Results and conclusion. In patients with cN0 cancer, only the size of primary tumor ≤1 cm was found to be a significant factor indicating that regional lymph nodes are not involved (in addition to palpation, ultrasound, mammography, and spiral x-ray computed tomography of the chest). In patients with сТ1c cancer, the majority of standard immunohistochemical markers cannot yet be used as predictors of regional lymph node involvement. However, tumor differentiation grade G1 is rather an exclusion, which in combination with the size of the primary tumor сТ1c can also be considered as a significant prognostic factor.
About the Authors
Yu. S. Shatova
Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
63 14th Line St., Rostov-on-Don 344037
L. N. Vashchenko
Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
63 14th Line St., Rostov-on-Don 344037
E. S. Bosenko
Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
63 14th Line St., Rostov-on-Don 344037
S. M. Bakulina
Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
63 14th Line St., Rostov-on-Don 344037
V. N. Kasyanenko
Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
63 14th Line St., Rostov-on-Don 344037
R. G. Luganskaya
Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
63 14th Line St., Rostov-on-Don 344037
N. S. Ratieva
Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
63 14th Line St., Rostov-on-Don 344037
References
1. Garcia-Etienne С.A., Mansel R.E., Tomatis M. et al. Trends in axillary lymph node dissection for early-stage breast cancer in Europe: Impact of evidence on practice. Breast 2019;45:89–96. DOI: 10.1016/j.breast.2019.03.002.
2. Veronesi U., Paganelli G., Viale G. et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 2003;349(6): 546–53. DOI: 10.1056/NEJMoa012782.
3. Mansel R.E., Fallowfield L., Kissin M. et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst 2006;98(9):599–609. DOI: 10.1093/jnci/djj158.
4. Krag D.N., Anderson S.J., Julian T.B. et al. Sentinel-lymph-node resection compared with conventional axillary-lymphnode dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol 2010;11(10):927–33. DOI: 10.1016/S1470-2045(10)70207-2.
5. Giuliano A.E., McCall L., Beitsch P. et al. Locoregional recurrence after sen tinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons On cology Group Z0011 randomized trial. Ann Surg 2010;252(3):426–32. DOI: 10.1097/SLA.0b013e3181f08f32.
6. Giuliano A.E., Hunt K.K., Ballman K.V. et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. J Am Med Ass 2011;305(6):569–75.
7. Galimberti V., Cole B.F., Zurrida S. et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol 2013;14:297–305.
8. Bonneau C., Hequet D., Estevez J.P. et al. Impact of axillary dissection in women with invasive breast cancer who do not fit the Z0011 ACOSOG trial because of three or more metastatic sentinel lymph nodes. EJSO 2015;41:998–1004.
9. Gentilini O., Veronesi U. Abandoning sentinel lymph node biopsy in early breast cancer? A new trial in progress at the European Institute of Oncology of Milan (SOUND: Sentinel node vs Observation after axillary UltraSouND). Breast 2012;21(5):678–681. DOI: 10.1016/j.breast.2012.06.013.
10. Straver M.E., Meijnen P., van Tienhoven G. Role of axillary clearance after a tumorpositive sentinel node in the administration of adjuvant therapy in early breast cancer. J Clin Oncol 2010;28(5):731–7.
11. Donker M., van Tienhoven G., Straver M.E. et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol 2014;15(12):1303–10. DOI: 10.1016/S1470-2045(14)70460-7.
12. Xing H., Song C.L., Li W.J. Meta-analysis of lymph node metastasis of breast cancer patients: clinical value of DWI and ADC value. Eur J Radiol 2016;85(6):1132–7. DOI: 10.1016/j.ejrad.2016.03.019.
13. Wright G.P., Mater M.E., Sobel H.L. et al. Measuring the impact of the American College of Surgeons Oncology Group Z0011 trial on breast cancer surgery in a community health system. Am J Surg 2015;209(2):240–5. DOI: 10.1016/j.amjsurg.2014.07.001.
14. Kit O.I., Maksimov A.Yu., Polupanov N.S. et al. Development of portable radionuclide diagnostics device for cancer diagnosis. Sovremennye problemy nauki i obrazovaniya = Current Problems of Science and Education 2019;1. Available at: http://science-education.ru/ru/article/view?id=28444 (In Russ.).
15. Krivorotko P.V., Tabagua T.T., Komyakhov A.V. et al. Sentinel lymph node biopsy in earlystage breast cancer: experience of N.N. Petrov Research Institute of Oncology. Voprosy onkologii = Problems in Oncology 2017;63(2):267–73. (In Russ.).
16. Zavagno G., Del Bianco P., Koussis H.G. et al. Clinical impact of false-negative sentinel lymph nodes in breast cancer. EJSO 2008;34:620–5.
17. Jianwei Z., Shuyan C., Huimin S. et al. Positive non-sentinel axillary lymph nodes in breast cancer with 1–2 sentinel lymph node metastases. Medicine 2018;97(4):13015.
18. Rodionov V.V., Panchenko S.V., Idrisova S.R. et al. Nomogram to predict the risk of regional lymph node metastasis in patients with early-stage breast cancer. Voprosy onkologii = Problems in Oncology 2015;61(3):435–8. (In Russ.).
19. Yun S.J., Sohn Y.M., Seo M. Risk stratification for axillary lymph node metastases in breast cancer patients: what clinicopathological and radiological factors of primary breast cancer can predict preoperatively axillary lymph node metastases? Ultrasound Q 2017;33(1):15–22. DOI: 10.1097/RUQ.0000000000000249.
20. Yoshihara E., Smeets A., Laenen A. et al. Predictors of axillary lymph node metastases in early breast cancer and their applicability in clinical practice. Breast 2013;22(3):357–61. DOI: 10.1016/j.breast.2012.09.003.
Review
For citations:
Shatova Yu.S., Vashchenko L.N., Bosenko E.S., Bakulina S.M., Kasyanenko V.N., Luganskaya R.G., Ratieva N.S. Role of clinical and morphological data in prediction of regional lymph node involvement in early-stage breast cancer. Tumors of female reproductive system. 2019;15(1):29-34. (In Russ.) https://doi.org/10.17650/1994-4098-2019-15-1-29-34
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