Axillary lymph node metastasis and survival in breast cancer patients with concurrent cardio-cerebral-vascular disease

OBJECTIVES Dissemination of tumour cells occurring both spontaneously or caused by diagnostic biopsy procedures is the most serious complication of solid malignancies. In the present work we focus on local tumour spread and how this complication of cancer disease can be counteracted. DESIGN From a cohort of 864 breast cancer patients we selected those who died of their primary cancer and those who died because of a simultaneously existing cardio-cerebral-vascular disease (CCVD) and were exposed to anticoagulants. SETTING The study was based on breast cancer patients diagnosed at Karolinska University Hospital during 1991 (n = 519) and 1997-1998 (n = 345). MAIN OUTCOME MEASURES Axillary lymph node metastasis (ALNM) and survival of breast cancer patients with concurrent CCVD. RESULTS Breast cancer patients belonging to the group that died of CCVD showed ALNM at the time of tumour diagnosis in 27% of the cases compared with 68% diagnosed in the group that died of their breast cancer (p < 0.0001). Likewise we observed a highly significant (p < 0.0001) difference in mean survival time with an average of 102 months in the group of breast cancer patients who died of CCVD and an average of 61 months in the group who died of breast cancer. CONCLUSION The data presented herein indicate that breast cancer patients regularly involved in treatment with anticoagulants because of simultaneously existing CCVD develop ALNM significantly less frequently and have an increased average survival time compared with breast cancer patients not suffering from CCVD.