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【Objective】 To investigate the clinicopathological characteristics of non-specific invasive breast cancer (IBC-NST) and the relationship between ipsilateral axillary lymph node metastasis and Ki-67 expression. 【Methods】 A total of 101 patients with IBC-NST were retrospectivily recruited and divided into two groups with high expression of Ki-67 (70cases) and low expression of Ki-67 (31cases). The χ2 test and Kruskal-Wallis H test were used to compare the clinical and pathological characteristics and other count data of patients between the groups. The comparison of ultrasound diagnosis of ipsilateral axillary lymph node metastasis and pathological results was calculated using correlation values such as sensitivity and specificity. The correlation between ipsilateral axillary lymph node metastasis and Ki-67 expression was analyzed with Spearman correlation analysis. 【Results】 In different Ki-67 expression groups, the size of tumor mass, histological grade of breast cancer, and clinical stage were statistically different between Ki-67 expression groups (P<0.05). The positive expression rate of tumor mass ≥2 cm (58.57%), histological grade Ⅲ (32.86%), clinical stages Ⅲ (34.29%) and Ⅳ (5.71%) was higher in the Ki-67 high expression group; ipsilateral axillary lymph node metastasis and Ki-67 high expression were positively correlated (r=0.393, P<0.05). 【Conclusion】 In IBC-NST cases, the tumor mass ≥ 2 cm, histological grade Ⅲ, clinical stage Ⅲ, and Ⅳ are correlated with the high expression of Ki-67. At the same time, ipsilateral axillary lymph node metastasis and Ki-67 high expression are positively correlated, which provides reference for IBC-NST proliferation assessment and clinical intervention.
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Objective:To investigate the clinical value of conventional ultrasound combined with automated breast volume scanner (ABVS) in predicting axillary lymph node metastasis (ALNM) of patients with invasive ductal carcinoma.Methods:A retrospective analysis was performed in 96 patients in the General Hospital of Eastern Theater Command from January 2014 to December 2020. All patients were examined by conventional ultrasound and ABVS before treatment. The patients were divided into the ALNM group and non-axillary lymph node metastasis (N-ALNM) group according to the postoperative pathological results. The differences of ultrasound parameters between the two groups were compared, and Logistic regression was used to analyze the independent predictive factors of ALNM. The ROC curve was plotted to evaluate the diagnostic efficacy for ALNM.Results:Compared with the N-ALNM group, the ALNM group had the characteristics of larger long diameters, unclear boundary, uneven internal echo, Adler blood flow grade Ⅱ-Ⅲ and retraction phenomenon (all P<0.05). Logistic regression analysis showed that the long diameter, uneven internal echo, and retraction phenomenon were independent predictors of ALNM ( OR=1.051, 4.055, 3.493, all P<0.05). The area under curve of ALNM was 0.752(0.653-0.834), the sensitivity and specificity were 54.7% and 83.7%, respectively. Conclusions:The long diameter, uneven internal echo, and retraction phenomenon measured by conventional ultrasound and ABVS are independent predictors of ALNM. The combination of the three can provide imaging references for the evaluation of ALNM of breast cancer.
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The status of axillary lymph nodes is important for the staging, treatment, and prognosis of breast cancer. The arrival of the era of precision medicine highlights the importance of axillary lymph nodes status assessment. Magnetic resonance imaging, positron emission tomography/computed tomography, and new imaging examinations can be used in the assessment of axillary lymph nodes, in addition to routine examinations, such as physical examination and breast ultrasound. Sentinel lymph node biopsy is the most significant method for the assessment of axillary lymph nodes. Emerging evidence suggests that axillary lymph node dissection can be avoided in patients with negative or 1–2 positive sentinel lymph nodes. The ratio of inflammatory indicators may be a reliable predictor of lymph node metastases. Specific elder patients can have a good prognosis without axillary procedure. In this paper, we review and summarize the controversies surrounding the assessment methods and management of axillary lymph nodes. We hope to provide new perspectives for the axillary lymph node diagnosis and management of breast cancer patients under the concept of precision therapy.
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Objective:To explore the feasibility of predicting axillary lymph node metastasis of breast cancer using radiomics analysis based on dynamic contrast-enhanced (DCE) MRI.Methods:The retrospective study enrolled 163 patients (163 lesions) with breast cancer diagnosed by core needle biopsy from January 2013 to December 2013 in Peking University First Hospital. The status of axillary lymph nodes in all patients was pathologically confirmed, and they had complete preoperative breast MRI images. Among the 163 patients, 94 patients were confirmed with axillary lymph node metastasis, and 69 patients without axillary lymph node metastasis. They were randomly divided into the training dataset ( n=115) and testing dataset ( n=48) in a 7∶3 ratio. The radiomics analysis was performed in the training dataset, including image preprocessing and labeling, radiomics feature extraction, radiomics model establishment and model predictive performance inspection. Model performance was tested in the testing dataset. Receiver operating characteristic curve and area under curve (AUC) was used to analyze the model prediction performance. Results:Of the 1 075 features extracted from the training dataset, principal component analyses (PCA) features 8, 41 and 67 were selected by random forest classifier. The radiomics model including 3 PCA features reached an AUC of 0.956 (95%CI 0.907-0.988), with sensitivity of 91.2%, specificity of 100% and accuracy of 94.8%. In the testing dataset, the radiomics model including 3 PCA features reached an AUC of 0.767 (95%CI 0.652-0.890), with sensitivity of 80.8%, specificity of 72.7% and accuracy of 77.1%.Conclusion:It is feasible to predict axillary lymph node metastasis using radiomics features based on DCE-MRI of breast cancer.
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Objective:To analyze the risk factors for lymph node metastasis in breast cancer patients with axillary lymph node metastasis after neoadjuvant chemotherapy.Methods:The data of 94 female patients with invasive breast cancer in Dongguan People′s Hospital of Guangdong Province from January 2017 to December 2019 were retrospectively analyzed.All patients planned to receive 4-8 cycles of neoadjuvant chemotherapy.After chemotherapy, modified radical mastectomy was performed.Estrogen receptor(ER), progesterone receptor(PR) and human epidermal growth factor receptor 2(HER-2) appeared for the first time in Chinese and English abstracts and texts positive patients received endocrine or targeted therapy.The rest patients received 2-4 cycles of adjuvant chemotherapy or radiotherapy according to the situation.Lymph node metastasis after neoadjuvant chemotherapy was analyzed.The relationship between lymph node metastasis after neoadjuvant chemotherapy and clinicopathological features was analyzed.Risk factors for lymph node metastasis after neoadjuvant chemotherapy were analyzed by Logistic regression.Results:After neoadjuvant chemotherapy, the positive rate of axillary lymph node was 74.47%(70/94). The number of positive axillary lymph nodes, ER status, HER-2 status and cell proliferation-associated human nuclear antigen(Ki67), the completion of chemotherapy cycle, the pathological remission of axillary lymph nodes after chemotherapy and the T stage of tumor after neoadjuvant chemotherapy were associated with lymph node metastasis in patients with positive axillary lymph nodes after neoadjuvant chemotherapy(χ 2=30.053, 10.233, 6.303, 7.666, 18.162, 10.148, 12.418; all P<0.05). More than 3 positive axillary lymph nodes( OR=2.788, 95% CI 1.253-5.318), ER positive( OR=3.298, 95% CI 1.744-7.837), Ki67 positive( OR=2.469, 95% CI 1.184-4.301)and pathological pPR( OR=4.197, 95% CI 2.168-13.788) were independent risk factors for lymph node metastasis after neoadjuvant chemotherapy(all P<0.05). Conclusion:Axillary lymph node-positive breast cancer patients have a high positive rate of axillary lymph nodes after neoadjuvant chemotherapy.More than 3 positive axillary lymph nodes before operation, ER positive, Ki67 positive, and axillary lymph node pPR after neoadjuvant chemotherapy are independent risk factors for lymph node metastasis after neoadjuvant chemotherapy.
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Thyroid carcinoma is the most common neoplasm of endocrine malignancies. Differentiated thyroid carcinoma (DTC) constitutes 90% of the thyroid carcinomas, rest being medullary thyroid carcinoma (MTC), and anaplastic thyroid carcinoma (ATC). Distant metastases occur in up to 10% of patients with DTC. Metastases to axillary lymph nodes (ALN) are very rare. As per literature, only 25 cases have been reported. We report an unusual case of 47-year-old male with Hürthle cell carcinoma of the thyroid presenting with a solitary axillary lymph node metastasis 17 years after thyroidectomy, along with review of literature.
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Humans , Male , Middle Aged , Lymph Nodes , Neoplasm Metastasis , Positron Emission Tomography Computed Tomography , Recurrence , Thyroid Carcinoma, Anaplastic , Thyroid Gland , Thyroid Neoplasms , ThyroidectomyABSTRACT
Objective To investigate the potential diagnosis value of tumor signal enhancement rate (SER)combined with long-to-short axis ratio of breast lumps in axillary lymph node metastasis in patients with breast cancer by using dynamic contrast-enhanced MRI (DCE-MRI).Methods patients with primary breast cancers were enrolled in the study,MR examinations were performed before surgeries.SER features and long-to-short axis ratio of breast lumps were obtained.Receiver operating characteristic curves (ROC) were plotted to assess the diagnostic performance.Results When MR SER ≥180.5% and long-to-short axis ratio of breast lumps ≤0.56,the diagnostic performance of the combination in terms of AUC was the highest (AUC=0.826),in comparison with that of MR SER or long-to-short axis ratio of breast lumps alone.The associated sensitivity and specificity were 93.8% (60/64)and 88.7% (47/53),respectively.Conclusion The combination of MR SER and long-to-short axis ratio of breast lumps can further improve the ability to identify lymph node metastasis in patients with breast cancer in DCE-MRI,and provide a reference basis for clinical therapy and prognosis.
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Objective:To investigate the clinicopathological characteristics of lung cancer patients with axillary lymph node metastasis (ALNM). Methods:The clinical data of 91 lung cancer patients with ALNM who were treated in Zhejiang Cancer Hospital from January 1st, 2007 to December 31st, 2013 were retrospectively analyzed. The relevance of the sites of the tumor site, local lymph node, and ax-illary lymph node was checked by contingency table. Survival rates were calculated by the Kaplan-Meier method and compared by a log-rank test. Cox proportional hazards model was applied to analyze the prognostic factors. Results:The proportion of lung cancer pa-tients with ALNM was 0.63%, and the patients were often presented with adenocarcinoma, peripheral tumor type, pleura invasion with pleural effusion, or chest wall invasion. A relationship between tumor sites, local lymph node sites, and axillary lymph node sites was observed. The median survival time of lung cancer patients with ALNM was 19.02 months, and the two-year survival rate is 62.64%. Patients identified with ALNM at the initial diagnosis reported poor prognosis (P=0.002). Cox regression analysis showed that the relative risk of death in patients with ALNM at initial diagnosis was elevated 2.18 times (95%CI:1.330?3.572, P=0.003). Conclu-sion:ALNM in lung cancer is rare, and it may involve through direct chest wall invasion and spread from supraclavicular and mediasti-nal lymph node metastasis or systemic origin. Patients detected with ALNM at the initial diagnosis indicated poor prognosis.
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Objective To explore the expression of HR and Her?2 in breast cancer primary tumor and axillary lymph node metastasis. Methods Four hundred and twenty?eight female patients with unilateral breast cancer combined with axillary lymph node metastasis treated in the Affiliated Suqian Hospital of Xuzhou Medical University from January 2011 to January 2016 were selected in this study. Immunohistochemistry was used to detect the expression of ER,PR,Her?2 and Ki67 in primary tumor and axillary lymph node metastasis. Results The positive rates of ER expression were 75. 9% ( 325/428 ) and 70. 3% ( 301/428 ) respectively in primary tumor and axillary lymph node metastasis. The positive rates of PR expression were 61. 4% ( 263/428) and 56. 1% ( 240/428 ) respectively in primary tumor and axillary lymph node metastasis. The rates of Her?2 overexpression were 20. 1% ( 86/428) in primary tumor and the positive rate of Her?2 in axillary lymph node metastasis was 22. 7%( 97/428 ) . The positive rates of Ki67 expression were 45. 6%( 195/428 ) and 39. 7%(170/428) respectively in primary tumor and axillary lymph node metastasis. The expression of ER,PR,Her?2 and Ki67 in primary and axillary lymph node metastasis showed no statistical significance ( P>0. 05 ) . The molecular typing of primary tumor and axillary lymph node metastasis were not consistent in 31 patients ( 31/428,7. 24%) ,including 14 cases of primary tumor Luminal A,9 cases of Her?2 overexpression in axillary lymph node metastasis and 5 cases of triple negative breast cancer. Primary tumor Luminal B was detected in 10 cases, while 6 cases of Her?2 overexpression in axillary lymph node metastasis and 4 cases of triple negative breast cancer. Primary tumor Her?2 was overexpressed in 4 cases,while 1 case of Luminal A,3 cases of Luminal B in axillary lymph node metastasis. There were 3 cases of primary tumor triple negative breast cancer,while 2 cases of Luminal B in axillary lymph node metastasis and 1 case of Her?2 overexpression. Conclusion The expressions of ER, PR, Her?2 and Ki67 in primary tumor and axillary lymph node metastasis of some breast cancer were different. Immunohistochemistry for primary tumor and axillary lymph node metastasis of stage II?III breast cancer patients should be routinely carried out. Based on molecular typing of primary tumor and axillary lymph node metastasis,individualized treatment plan can be developed,so that patients will benefit from it.
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Occult breast cancer is a rare disease with the primary symptom of enlarged ipsilateral axillary lymph node. At present,it is still difficult to diagnose occult breast cancer. The diagnosis is based on the core needle biopsy and following immunohistochemical staining for the enlarged lymph nodes. If the results support,the diagnosis can be confirmed after the exclusion of other primary tumors. The standard treatment of occult breast cancer is still the mastectomy and axillary lymph node dissection. Neoadjuvant chemotherapy is an independent factor affecting the prognosis,which is also recommended before the oper-ation. Chemotherapy,radiotherapy and endocrine therapy could be chosen based on immunohistochemical results after surgical treatment. The prognosis of occult breast cancer is similar to the other types of breast cancer at the same staging.
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Background and purpose:Axillary lymph node metastasis of breast cancer has an important significance in prognosis and treatment of breast cancer. This study was to investigate the correlation between axillary lymph node metastasis and ultrasonographic characteristics of axillary lymph node combined with immunohistochemistry in breast cancer patients.Methods:A total number of 366 breast cancer patients were selected in this study. Seven hundred and twenty-eight axillary lymph nodes were collected. With ultrasonography, the maximum cortex thickness, the ratio of the height to the length, the ratio of the cortex to the medulla and blood lfow of axillary lymph nodes were observed, in order to study the correlation between these indicators and axillary lymph node metastasis combined with the postoperative immunohistochemical results.Results:According to univariate analysis, axillary lymph node maximum cortex thickness, the ratio of the height to the length, characteristics of blood flow and the positive expression rate of p53 were related to axillary lymph node metastasis (P3 mm (42.78%) of axillary lymph node was signiifcantly higher than that in patients with maximum cortex thickness≤3 mm (25.82%) (P<0.01).Conclusion:Ultrasonographic characteristics of axillary lymph node and immunohistochemistry method are closely correlated with axillary lymph node metastasis in patients with breast cancer, which is important in diagnostic and treatment in clinic.
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Objective To investigate the relationships between axillary lymph node metastasis and clinicopathologic features in the patients with cT1-2 N0 breast cancer and clarify the law of axillary lymph node metastasis,and to find the risk factor,and provide the theoretical basis for individuation therapy.Methods 687 patients with cT1-2 N0 breast cancer were divided into negative group and positive group according to the pathological results of axillary lymph node,and the clinicopathologic features were layered.The risk factors of axillary lymph node metastasis were screened out by Chi-square test and Logistic regression analysis.Results In 687 cases of cT1-2 N0 breast cancer,156 (22.7%)cases were observed with axillary lymph node metastasis. The age,cT stage,pT stage, pathological type,vascular invasion,perineural invasion estrogen receptor (ER),progesterone receptor (PR), and molecular subtyping were the factors that influenced axillary lymph node metastasis in univariate analyses.The age < 35 years, cT2 , invasive ductal carcinoma, vascular invasion positive and Luminal subtyping were the independent risk factors of axillary lymph nodes metastasis in multivariate analyses (r = 3.440,P = 0.010;r =1.770,P =0.007;r = 3.397,P = 0.001;r = 7.434,P = 0.000;r = 2.212,P = 0.015).Conclusion In the patients with cT1-2 N0 breast cancer,the age,cT,pathological type,vascular invasion and molecular subtyping are important predictors of axillary lymph node metastasis and vascular invasion was the most important predictor.The preoperative comprehensive analysis and evaluation of clinical data and preoperative pathological results obtained will help to select the right surgical operation.
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Objective To explore the diagnostic value of MRI special use of breast and uhrasonography in axillary lymph node metastasis of early breast cancer.Methods Clinical data of 136 Ⅰ-Ⅲ A breast cancer patients accepted MRI examination before surgery had been retrospectively studied,analysing diagnostic value of MRI and ultrasonography in axillary lymph node metastasis of early breast cancer.Results The sensitivity,specificity,and accuracy obtained by MRI were 83.3％,88.6％ and 86.3％.And these data of ultrasonography were 73.1％,76.7％ and 75.0％.The sensitivity,specificity,and accuracy obtained MRI were better than that of ultrasonography.The sensitivity,specificity,and accuracy of ≥ 50 years old patients were 70.0％,77.8％ and 75.0％.And ＜ 50 years old patients were 85.7％,92.3％ and 88.9％.The sensitivity,specificity,and accuracy of ＜ 50 years old patients were better than ≥ 50 years old patients.Conclusions The MRI special use of breast have an important value in axillary lymph node metastasis of early breast cancer,especially to gounger than 50 years old patients.It can provide a scientific basis of the clinical accurate treatment for early breast cancer patients.
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Objective:This study aimed to investigate the clinical significance of hormone receptor status detection in simultane-ous axillary metastasis for hormone receptor-negative primary breast cancer patients. Methods:Using immunohistochemical methods, hormone receptor status detection in axillary lymph node metastasis was performed among breast cancer patients with simultaneous ax-illary metastasis in the First Affiliated Hospital of Chongqing Medical University. The subjects comprised patients who visited the clin-ic for follow up or those who were hospitalized from July 2012 to January 2013. Endocrine therapy was given for patients diagnosed with positive hormone receptor in their simultaneous axillary metastasis. Results:Out of 56 patients with hormone receptor-negative primary breast cancer, 14.3%gained estrogen receptor (ER), 3.6%gained progesterone receptor (PR), and 5.4%gained ER and PR in their simultaneous axillary metastasis, and then underwent endocrine therapy. The discordance rate of hormone receptor expression be-tween primary tumor and axillary metastasis was 23.3%. Conclusion:Some discordance rates of hormone receptor status between pri-mary tumor and simultaneous axillary metastasis were observed. Through hormone receptor status detection in simultaneous axillary metastasis, we may possibly distinguish patients with negative ER and PR, among whom endocrine therapy may be active.
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Objective: The aim of this study was to explore the association of different molecular subtypes with the clinicopathologic features and the prognosis in breast cancer patients with axillary lymph node metastasis. Methods: The clinicopathologic information of 181 operable breast cancer patients with axillary lymph node metastasis was retrospectively analyzed. These patients were classified into different groups according to molecular subtyping. All patients were followed-up with a median of 58 months (range: 44-68 months). The multivariate analysis was performed to evaluate the prognostic indicators among the potential factors including age, primary tumor size, number of metastatic axillary lymph nodes and molecular subtype. Results: Of all 181 patients, 58.0% (105/181) were luminal subtype, 24.3% (44/181) were basal-like subtype, and 17.7% (32/181) were HER-2 overexpression subtype. HER-2 overexpression was closely associated with increased tumor size and more positive lymph nodes. The relapse rates of luminal, basal-like and HER-2 overexpression subtypes were 17.1% (18/105), 31.8% (14/44) and 37.5% (12/32), respectively (P = 0.026); the death rates of luminal, basal-like and HER-2 overexpression subtypes were 6.7% (7/105), 13.6% (6/44) and 18.8% (6/32), respectively (luminal vs non-luminal, P = 0.048). The five-year disease-free survival rate of patients with luminal subtype was much higher than those of the patients with HER-2 overexpression and basal-like subtypes (log-rank test, P = 0.025); the five-year overall survival rate of patients with luminal subtype was also much higher than that of patients with HER-2 overexpression subtype (log-rank test, P = 0.039). COX proportional hazards model revealed that primary tumor size and the number of metastatic axillary lymph nodes were both independent prognostic indicators (P > 0.05). Conclusion: In axillary lymph node-positive breast cancer patients not receiving targeted molecular therapy, the subtype of HER-2 overexpression has the worst prognosis while the subtype of luminal has the best. The primary tumor size and the number of metastatic axillary lymph nodes were both independent prognostic indicators for breast cancer patients. Copyright © 2013 by TUMOR.
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PURPOSE: The axillary lymph node status is the most significant prognostic factor in breast cancer. The development of tools to accurately evaluate the axillary lymph node status with less morbidity has been the important treatment issue. Although sentinel lymph node biopsy is the promising alternative to axillary lymph node dissection, the high false negative rate of this procedure is a considerable problem. This study aimed to evaluate the efficacy of performing preoperative axillary ultrasonography (US) for predicting axillary lymph node metastasis. METHODS: Between January 2003 and December 2004, preoperative axillary US was performed in 646 patients who were suffering with T1 or T2 infiltrating ductal carcinoma and they had no palpable axillary lymph nodes. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of preoperative axillary US findings were 82.8%, 93.2%, 86.3%, 91.2%, and 89.6%, respectively. The positive and negative predictive values for performing axillary US findings for tumors with a size 2cm, the positive and negative predictive values were 90.6 and 89.4, respectively. CONCLUSION: We found that performing preoperative axillary US is a relatively accurate and useful non-invasive method for assessing axillary lymph node metastasis. It showed the potential to replace sentinel lymph node biopsy in tumors > or = 2cm in size with low false negative rate. If we can improve the positive predictive value of US finding by using strict decision criteria, and especially for the tumors >2cm in size, then axillary lymph node dissection might be recommended for the cases with positive US finding.
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Humans , Axilla , Breast Neoplasms , Breast , Carcinoma, Ductal , Lymph Node Excision , Lymph Nodes , Neoplasm Metastasis , Sensitivity and Specificity , Sentinel Lymph Node Biopsy , UltrasonographyABSTRACT
PURPOSE: With the increasing use of neoadjuvant chemotherapy and minimally invasive therapy, the accuracy of preoperative determination of breast tumor size and axillary lymph node status become more important. The purpose of this study was to correlate physical examination, mammographic, and ultrasonographic measurements of tumor size and regional lymph node status with pathologic findings and to evaluate the accuracy of various preoperative examination methods. METHODS: Ninety patients presenting with palpable primary breast cancer treated with mastectomy or breast conserving surgery with axillary dissection were measured breast tumor size and axillary lymph node status by physical examination, mammography, and high resolution duplex ultrasonography, and correlated with the values obtained at pathologic examinations. RESULTS: The sensitivity of mammography and sonography for breast tumor were 82.5% and 90.8%, respectively. The average diameter of tumors was 3.39+/-1.77 cm on pathologic examination. Physical examination demonstrated the highest correlation coefficient (r=0.759) in measurement of the tumor size. The sensitivity of physical examination mammography, and sonography for axillary node involvement were 37.5%, 57.7%, and 73.9%, respectively, and with specificity of 98.1%, 86.5%, and 92.9%, respectively, and with positive predictive value of 93.8%, 75.0%, and 85.0%, respectively. CONCLUSION: Physical examination is the best non-invasive predictor of the real size of palpable primary breast cancer, whereas high resolution duplex ultrasonography is most sensitive assessment method of axillary lymph node status. The specificity of axillary nodal status can be increased by fine-needle biopsy under sonographic guidance and it can be serve as useful adjuncts to sentinel node biopsy.
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Humans , Biopsy , Biopsy, Fine-Needle , Breast Neoplasms , Breast , Drug Therapy , Lymph Nodes , Mammography , Mastectomy , Mastectomy, Segmental , Neoplasm Metastasis , Physical Examination , Sensitivity and Specificity , UltrasonographyABSTRACT
PURPOSE: Reliable prognostic factors, including clinicopathological parameters (Ed-alternatively, "Reliable clinicopathologic prognostic factors") such as tumor size, axillary lymph node involvement, histologic grade, menopausal patient status and steroid receptor status, are necessary in the management of breast cancer for predicting clinical course and as guide lines for adjuvant therapy. Recently, many reports have shown that expression of p53 and c-erbB-2 products is associated with poor prognosis. To elucidate the clinical value of p53 and c-erbB-2 protein expression as prognostic factors, their immunoreactivities were compared with known clinicopathologic prognostic factors. METHODS: The expressions of p53 and c-erbB-2 proteins were analyzed by immunohistochemical method with formalin-fixed and paraffin-embedded tissue samples of 71 invasive breast carcinomas accumulated between 1996 and 1999 at Chungbuk National University Hospital. The expressions of p53 and c-erbB-2 proteins were compared with established prognostic factors such as tumor size, axillary lymph node involvement, histologic grade, menopausal patient status and steroid hormone receptor status. Statistical significance was analyzed by chi-square test. RESULTS: The immunoreactivities of p53 and c-erbB-2 proteins were detected in 29.6% and 46.5%, respectively, of the samples. p53 positivity was significantly higher in breast car-cinoma that showed higher histologic grade or was metastasized to more than 3 axillary lymph nodes (P<0.05). There were no significant correlations between c-erbB-2 positivity and known clinicopathologic prognostic factors. CONCLUSION: This study suggests that expression of p53 protein could be used as a prognostic indicator in the management of breast cancer. But the impact of p53 and c- erbB-2 protein expression on overall survival and disease free survival rates should be evaluated further before being used as independent prognostic factors.
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Humans , Breast Neoplasms , Breast , Disease-Free Survival , Lymph Nodes , Prognosis , Receptor, ErbB-2 , Receptors, SteroidABSTRACT
PURPOSE: Reliable prognostic factors, including clinicopathological parameters (Ed-alternatively, "Reliable clinicopathologic prognostic factors") such as tumor size, axillary lymph node involvement, histologic grade, menopausal patient status and steroid receptor status, are necessary in the management of breast cancer for predicting clinical course and as guide lines for adjuvant therapy. Recently, many reports have shown that expression of p53 and c-erbB-2 products is associated with poor prognosis. To elucidate the clinical value of p53 and c-erbB-2 protein expression as prognostic factors, their immunoreactivities were compared with known clinicopathologic prognostic factors. METHODS: The expressions of p53 and c-erbB-2 proteins were analyzed by immunohistochemical method with formalin-fixed and paraffin-embedded tissue samples of 71 invasive breast carcinomas accumulated between 1996 and 1999 at Chungbuk National University Hospital. The expressions of p53 and c-erbB-2 proteins were compared with established prognostic factors such as tumor size, axillary lymph node involvement, histologic grade, menopausal patient status and steroid hormone receptor status. Statistical significance was analyzed by chi-square test. RESULTS: The immunoreactivities of p53 and c-erbB-2 proteins were detected in 29.6% and 46.5%, respectively, of the samples. p53 positivity was significantly higher in breast carcinoma that showed higher histologic grade or was metastasized to more than 3 axillary lymph nodes (P<0.05). There were no significant correlations between c-erbB-2 positivity and known clinicopathologic prognostic factors. CONCLUSION: This study suggests that expression of p53 protein could be used as a prognostic indicator in the management of breast cancer. But the impact of p53 and c- erbB-2 protein expression on overall survival and disease free survival rates should be evaluated further before being used as independent prognostic factors.
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Humans , Breast Neoplasms , Breast , Disease-Free Survival , Lymph Nodes , Prognosis , Receptor, ErbB-2 , Receptors, SteroidABSTRACT
PURPOSE: The axillary lymph node status is the most important prognostic factor in breast cancer. The axillary node dissection is done are usually performed in infiltrating breast cancer for the information of therapeutic decision and prediction of prognosis. But this procedure results in lymphedema of affected upper extremity nearly about 25%, increased axillary drainage, sensory abnormality and pain. Many researches are focussed to find the patients group who do not need axillary dissection according to the status of tumor size, patient age, hormonal receptor and histologic grade. MATERIAL AND METHODS: We evaluated the axillary lymph node status related with tumor size less then 2 cm in and the correlation of other prognostic factor. We reviewed 127 women with histologically diagnosed infiltrating ductal carcinoma of breast who were treated by one surgeon at YongDong Severance Hospital, Yonsei University College of medicine between 1991 and 1996. RESULTS: Five patients (3.9%) had T1a lesion (< 5 mm), 24 patients (18.9%) had T1b tumors (6-10 mm), and 98 cases (77.2%) had T1c lesion (11-20 mm). The average numbers of dissected axillary lymph nodes were 14.2 We found that small tumor size, good histologic grade, estrogen receptor positivity, old age (over 50 years) showed tendency of decreased axillary node metastasis but without statistical significance. CONCLUSIONS: There are possibility of finding subset with low risk of axillary lymph node metastasis in small size tumor with addition of good prognostic indicators such as good histologic grade, hormonal receptors and old age.