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 grading
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.