The factors influencing axillary lymph node metastasis
in patients with T1 invasive ductal carcinoma |
Seung Yeon Park, Heung Kyu Park |
Department of Surgery, Gachon Medical University, Gil hospital |
T1 침윤성 유관암에서 액와부 림프절 전이에 영향을 주는 인자들 |
박승연, 박흥규 |
가천의과대학교 길병원 외과학교실 |
Corresponding Author:
Heung Kyu Park ,Tel: +82-32-460-3244, Fax: +82-32-460-3247, Email: hgjh@gilhospital.com |
Received: November 20, 2010; Accepted: December 23, 2010. |
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ABSTRACT |
Background: Due to the increment of general interest in breast cancer and the early screening examination, the
rate of early breast cancer is relatively increasing, along the rate of the successful treatment. Even at the earlier
stage of breast cancer, the process of axillary lymph node metastasis is significant for treatment and prognosis of
the cancer. Therefore, the aim of the study is to identify the factors that influence the lymph node metastasis
among the patients with T1 breast cancer.
Methods: Between January 2003 and May 2008, 204 patients diagnosed as infiltrating ductal carcinoma after the
breast cancer resection at Gachon University Gil Hospital were enrolled in this study. Each patient°Øs age, size and
location of cancer, number of tumor, tissue and nuclear grade, infiltration of lymph vessels,
immunohistochemistry test result (ER, PR, p53, HER2, Ki67, etc.), and axillary lymph node status were compared.
Results: 10 out of 204 patients had cancer smaller than 0.5 cm(T1a), 22 patients had cancer size larger than 0.5 cm
and smaller than 1cm(T1b), and 172 patiens had cancer size larger than 1cm(T1c). For the rate of axillary lymph
node metastasis, in the group of T1a, 1/10 (10%) patients showed axillary lymph node metastasis, in T1b,
2/22(9.1%) patients showed axillary lymph node metastasis and in T1c, 54/172(31.3%) patients showed axillary
lymph node metastasis. The result distinguished by the size of the cancer was statistically significant (p=0.039).
The number of tumor was sorted as 1, 2, and more than 3, and each integer was 179, 17, and 8 patients. The rate of
axillary lymph node metastasis according to the number of tumor was 48/179 (26.8%) with 1 tumor, 5/17(29.4%)
with 2 tumors, and 4/8 (50%) with more than 3 tumors. This result distinguished by the number of tumor was also
statistically significant (p=0.007). Also, Lymphovascular invasion was statistically significant(p=0.001). The rate of
axillary lymph node metastasis did not show the statistical significance with the age of patients, location of cancer,
tissue and nuclear grade, and immunohistochemistochemical staining result.
Conclusion: It is considered that the size and the number of tumor, and lymphovascular infiltration are the
significant factors influencing axillary lymph node metastasis of the T1 invasive ductal carcinoma. Furthermore, it
is expected that the size and the number of tumor in preoperative ultasonography will be helpful determining the
axillary lymph node dissection. |
Keywords:
T1 invasive ductal carcinoma | axillary lymph node metastasis |
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