Extra-nodal extension is a significant prognostic factor in lymph node positive breast cancer
نویسندگان
چکیده
Presence of lymph node (LN) metastasis is a strong prognostic factor in breast cancer, whereas the importance of extra-nodal extension and other nodal tumor features have not yet been fully recognized. Here, we examined microscopic features of lymph node metastases and their prognostic value in a population-based cohort of node positive breast cancer (n = 218), as part of the prospective Norwegian Breast Cancer Screening Program NBCSP (1996-2009). Sections were reviewed for the largest metastatic tumor diameter (TD-MET), nodal afferent and efferent vascular invasion (AVI and EVI), extra-nodal extension (ENE), number of ENE foci, as well as circumferential (CD-ENE) and perpendicular (PD-ENE) diameter of extra-nodal growth. Number of positive lymph nodes, EVI, and PD-ENE were significantly increased with larger primary tumor (PT) diameter. Univariate survival analysis showed that several features of nodal metastases were associated with disease-free (DFS) or breast cancer specific survival (BCSS). Multivariate analysis demonstrated an independent prognostic value of PD-ENE (with 3 mm as cut-off value) in predicting DFS and BCSS, along with number of positive nodes and histologic grade of the primary tumor (for DFS: P = 0.01, P = 0.02, P = 0.01, respectively; for BCSS: P = 0.02, P = 0.008, P = 0.02, respectively). To conclude, the extent of ENE by its perpendicular diameter was independently prognostic and should be considered in line with nodal tumor burden in treatment decisions of node positive breast cancer.
منابع مشابه
بررسی رابطه بین شاخص توموری 2-Her و قدرت تهاجمی سرطان پستان(متاستاز به غدد لنفاوی زیر بغل) در بیماران ماستکتومی شده در انستیتو کانسر طی سالهای 82-1380
Breast cancer is the most common site-specific cancer and is the second cause of mortality due to cancer in women. There are different prognostic factors including: axillary nodal status and tumor size(the most important factor), ER activity, PR, tumor grade and the type of histology. Other incompletely defined risk factors are: protease, catepstin, Her-2, etc. Her-2 is subtype 2 of E...
متن کاملExtra-nodal extension of sentinel lymph node metastasis is a marker of poor prognosis in breast cancer patients: A systematic review and an exploratory meta-analysis.
Invasive breast cancer is the most common malignancy in women. Its most common site of metastasis is represented by the lymph nodes of axilla, and the sentinel lymph node (SLN) is the first station of nodal metastasis. Axillary SLN biopsy accurately predicts axillary lymph node status and has been accepted as standard of care for nodal staging in breast cancer. To date, the morphologic aspects ...
متن کاملEvaluation of extra capsular lymph node involvement in patients with extra-hepatic bile duct cancer
BACKGROUND Lymph node metastasis is one of the most important prognostic factors for extra-hepatic bile duct carcinoma (ExHBDC). Extra capsular lymph node involvement (ExCLNI) is the extension of cancer cells through the nodal capsule into the perinodal fatty tissue. The prognostic impact of ExCLNI has been shown to be significant mainly in head and neck malignancies. Recently, the prognostic i...
متن کاملارتباط بین واکنشهای استرومال لنفوسیتی و درگیری گرههای لنفاوی آگزیلا در کارسینومهای داکتال مهاجم درجهی یک پستان
Background & objective: Breast cancer is the most common cancer in women. Lymph node involvement is the most important prognostic factor in this cancer. Since there is no consensus about the relationship between lymphocytic infiltration and breast cancer prognosis, this study was conducted to investigate the correlation between stromal lymphocytic reaction and lymph node involvement in grade 1 ...
متن کاملPrognostic Value of Lymph Node Ratio in comparison to Lymph Node Metastases in Stage III Colon Cancer
Background & Objectives: Colon cancer is currently of high incidence and mortality rate. Identifying the factors influencing its prognosis can be very beneficial to its clinical treatment. Recent studies have shown that lymph nodes ratio can be considered as an important prognostic factor. The aim of the present study is to investigate the effect of this factor on the prognosis of the ...
متن کامل