ABSTRACT
Background: Surgical dissection is the accepted mode of staging the axilla in breast cancer. Proper prediction of axillary node positivity can help towards stratifying patients. The primary objective of the study was to assess the clinical factors influencing pathological axillary lymph node positivity in early carcinoma breast.Methods: This was a retrospective study, conducted at a tertiary cancer centre. Case records of all the patients with invasive breast cancer which are clinical T1 and T2 and either N0 or NI, from January 2011 to October 2014 were analysed. Clinical profile of the patient including age, BMI, comorbid, menstrual history, family history, symptoms, site of the lesion, size, single or multi centric origin were analysed.Results: Total of 608 patients of early breast cancer analysed of which 248 had pathological nodal positivity. The age group of 51 to 75 years, BMI ≥30, pre-menopausal patients had significant positive predictive value when compared to post-menopausal. Tumours in lower outer quadrant, central sector and multiple tumours also had positive predictive value. Clinical T2 when compared to clinical T1 stage and MRM when compared to BCS had significant positive predictive value.Conclusions: To conclude in present study age of the patient and clinical location of the tumour and surgery performed emerged as significant independent predictive factors of positive lymph node. Prospective studies are required to further prove the significance of these factors.
ABSTRACT
Background: Most endometrioid endometrial cancer are well differentiated (Grade I). Grade of the tumor is an important predictor of nodal metastasis and the discordance in histological grade of endometrial cancers between diagnostic biopsy and definitive surgery specimen was analyzed in our Institute.Methods: Around 221 patients diagnosed with carcinoma endometrium between 2006 and 2014 were taken into study. Histologic differentiation of the tumour between diagnostic biopsy and definitive surgery were analysed. All demographic data, tumor factors, follow up and recurrence were recorded.Results: Of the 221 patients taken into consideration for analysis, median age of presentation was 57 years with range between 38-77 years. The overall median body mass index was 27.70kg/m2. 66 % of patients had comorbid illness, with 33% having both diabetes and hypertension. Open staging was performed in 150 patients and laparoscopic staging in 71 patients. Mean duration of surgery was 3.06 hrs in laparoscopic staging and 2.74hrs in open staging. The median tumour size was 4cm.The median number of nodes dissected were 13. Discordance in the grade of tumour between diagnostic biopsy and surgical biopsy were 58.8% of grade 1 tumour, 16.2% of grade 2 tumours and 18.9% of grade 3 tumours.Conclusions: Discrepancies in correlation of the grade of tumour in diagnostic biopsy and tissue obtained at surgery supports the need for surgical staging in all patients.