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Axillary lymph node metastases associated with small invasive breast carcinomas.
D C Maibenco1, L K Weiss, K S Pawlish
1Department of Surgery, Detroit Medical Center/Sinai Hospital, Michigan, USA.
Cancer
|April 8, 1999
Summary
Small invasive breast cancers (≤1 cm) have varying lymph node metastasis risks based on tumor size, histology, grade, and patient age. Certain early-stage tumors may not require axillary lymph node dissection.
Area of Science:
- Oncology
- Surgical Oncology
- Pathology
Background:
- The incidence of small invasive breast carcinomas (≤1 cm) has risen over the last two decades.
- Limited data exists on how clinical and histological factors influence lymph node metastasis in these small tumors.
Purpose of the Study:
- To investigate the relationship between clinical and histological characteristics and the frequency of lymph node metastases in invasive breast carcinomas measuring ≤1 cm.
Main Methods:
- Utilized Surveillance, Epidemiology, and End Results (SEER) data from January 1988 to December 1993.
- Included 12,950 patients with invasive breast carcinomas ≤1 cm who underwent primary tumor resection and axillary lymph node dissection.
- Analyzed the impact of clinical and histological variables on lymph node metastasis rates.
Main Results:
- T1a tumors showed a lower metastasis rate (9.6%) than T1b tumors (14.3%).
- Favorable histology (mucinous, papillary, tubular) had significantly lower metastasis rates (3.9%) compared to other types (13.9%).
- Metastasis risk increased with histologic grade (7.8% for Grade 1 to 21.0% for Grade 4) and decreased with patient age (22.6% for <40 years to 10.2% for ≥70 years).
Conclusions:
- Identified specific tumor types (T1a/T1b mucinous/tubular, T1a papillary, T1a Grade 1) with metastasis risk ≤5%.
- These findings suggest that axillary lymph node dissection may be avoidable in select cases of small invasive breast carcinoma.