Relationship of Sonographic Tumor Size and Grading of Invasive Ductal Carcinoma; Not Otherwise Specified (IDC; NOS) of Breast Cancer on Axillary Nodal Metastasis
Keywords:
Breast cancer, Axillary lymph node metastasis, Tumor size, Tumor gradingAbstract
Introduction: Axillary nodal involvement is an essential prognostic factor in patients with breast cancer. Both mammogram and ultrasound are used for preoperative axillary nodal staging. Increasing pathological tumor size and higher tumor grade are significantly associated with an increased risk of axillary lymph node metastasis. Our objective was to evaluate the relationship between sonographic tumor size and grading of invasive ductal carcinoma; not otherwise specified (IDC; NOS) of breast cancer and axillary nodal metastasis.
Method: A retrospective review to all patients with cytology-proven IDC; NOS at Thammasat University Hospital (TUH) from January 2013 to June 2017. To evaluate the relationship of sonographic tumor size and grading on axillary nodal metastasis, we constructed multivariable logistic regression models adjusted for age, tumor size and tumor grading. Result: Total 204 eligible patients, 118 (57.8%) were positive axillary lymph node status. In comparison, tumor size was larger in positive axillary lymph node status patients; median
25 mm (min 10 - max 117 mm) vs 20 mm (min 5 - max 60 mm), P = 0.001. Larger tumor size was associated with more axillary lymph node metastasis (adjusted odds ratio 1.49, 95% confidence interval; 1.11-1.91, P = 0.002). For tumor grading, there was no significantly
associated with axillary lymph node metastasis.
Conclusion: Sonographic tumor size can be used as a predictive value in breast cancer. Larger tumor of IDC; NOS was associated with more axillary lymph node metastasis.
Downloads
References
American Cancer Society. Breast Cancer Facts & Figures 2015-2016. Atlanta: American Cancer Society, Inc; 2015.
Sinn HP, Kreipe H. A Brief Overview of the WHO Classification of Breast Tumors, 4th Edition, Focusing on Issues and Updates from the 3rd Edition. Breast Care. 2013;8(2):149-154.
Carter CL, Allen C, Henson DE. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases. Cancer. 1989;63(1):181-187.
Chen SL, Iddings DM, Scheri RP, Bilchik AJ. Lymphatic mapping and sentinel node analysis: current concepts and applications. CA Cancer J Clin. 2006;56(5):292-317. doi:10.3322/canjclin.56.5.292.
Brenin DR, Morrow M. Conventional axillary dissection: Extent, local control, and morbidity. Semin Breast Dis. 1998;1:118–124.
Schrenk P, Rieger R, Shamiyeh A, Wayand W. Morbidity following sentinel lymph node biopsy versus axillary lymph node dissection for patients with breast carcinoma. Cancer. 2000;88(3):608-614.
Le Doussal V, Tubiana-Hulin M, Friedman S, Hacene K, Spyratos F, Brunet M. Prognostic value of histologic grade nuclear components of Scarff-Bloom-Richardson (SBR). An improved score modification based on a multivariate analysis of 1262 invasive ductal breast carcinomas. Cancer. 1989;64(9):1914-1921.
Rivadeneira DE, Simmons RM, Christos PJ, Hanna K, Daly JM, Osborne MP. Predictive factors associated with axillary lymph node metastases in T1a and T1b breast carcinomas: analysis in more than 900 patients. J Am Coll Surg. 2000;191(1):1-8. doi:10.1016/s1072-7515(00)00310-0.
Brenin DR, Manasseh DM, El-Tamer M, et al. Factors correlating with lymph node metastases in patients with T1 breast cancer. Ann Surg Oncol. 2001;8(5):432-437. doi:10.1007/s10434-001-0432-7.
Sek P, Piekarski J, Kubiak R, et al. Tumor Size and Pathologic Characteristics of Breast Cancer Analysis of 639 Early Breast Cancers. Polish Journal of Surgery. 2007:78-84. doi: 10.2478/v10035-007-0013-y.
Wu JL, Tseng HS, Yang LH, et al. Prediction of axillary lymph node metastases in breast cancer patients based on pathologic information of the primary tumor. Med Sci Monit. 2014;20:577-581. doi:10.12659/MSM.890345.
Garg M, Nagpal N, Sidhu DS, Singh A. Effect of Lump Size and Nodal Status on Prognosis in Invasive Breast Cancer: Experience from Rural India. J Clin Diagn Res. 2016;10(6):8-11. doi:10.7860/JCDR/2016/20470.8039.
Yang WT, Lam WW, Cheung H, Suen M, King WW, Metreweli C. Sonographic, magnetic resonance imaging, and mammographic assessments of preoperative size of breast cancer. J Ultrasound Med. 1997;16(12):791-797. doi:10.7863/jum.1997.16.12.791.
Tresserra F, Feu J, Grases PJ, Navarro B, Alegret X, Férnandez-Cid A. Assessment of breast cancer size: sonographic and pathologic correlation. J Clin Ultrasound. 1999;27(9):485-491. doi:10.1002/(sici)1097-0096(199911/12)27:9<485::aid-jcu1>3.0.co;2-c.
Hieken TJ, Harrison J, Herreros J, Velasco JM. Correlating sonography, mammography, and pathology in the assessment of breast cancer size. Am J Surg. 2001;182(4):351-354. doi:10.1016/s0002-9610(01)00726-7.
Cortadellas T, Argacha P, Acosta J, et al. Estimation of tumor size in breast cancer comparing clinical examination, mammography, ultrasound and MRI-correlation with the pathological analysis of the surgical specimen. Gland Surg. 2017;6(4):330-335. doi:10.
/gs.2017.03.09.
Sabek EAS, Salem HT. Technical Factors Affecting Ultrasound Breast Tumor Size as Correlated with Pathological Type. Medicina (Kaunas). 2019;55(11):713. doi:10.3390/medicina55110713.
Finlayson CA, MacDermott TA. Ultrasound can estimate the pathologic size of infiltrating ductal carcinoma. Arch Surg. 2000;135(2):158-159. doi:10.1001/archsurg.135.2.158.
Pritt B, Ashikaga T, Oppenheimer RG, Weaver DL. Influence of breast cancer histology on the relationship between ultrasound and pathology tumor size measurements. Mod Pathol. 2004;17(8):905-910. doi:10.1038/modpathol.3800138.
Velanovich V, Szymanski W. Lymph node metastasis in breast cancer: common prognostic markers lack predictive value. Ann Surg Oncol. 1998;5(7):613-619. doi:10.1007/BF02303831.
Gill PG, Luke CG, Roder DM. Clinical and pathological factors predictive of lymph node status in women with screen-detected breast cancer. Breast. 2006;15(5):640-648. doi: 10.1016/j.breast.2006.01.009.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
