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Related Experiment Videos

Variability in axillary lymph node dissection for breast cancer.

Michael Schaapveld1, Renée Otter, Elisabeth G E de Vries

  • 1Comprehensive Cancer Center North-Netherlands (CCCN), Groningen, The Netherlands. m.schaapveld@ikn.nl

Journal of Surgical Oncology
|June 29, 2004
PubMed
Summary

Breast cancer staging varies due to inconsistent lymph node reporting. More examined nodes increase positive node detection, impacting treatment decisions and potentially leading to misclassification for adjuvant therapies.

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Area of Science:

  • Oncology
  • Pathology
  • Surgical Oncology

Background:

  • Axillary lymph node status is crucial for breast cancer prognosis and adjuvant treatment selection.
  • Variability in reporting axillary lymph nodes can affect nodal staging accuracy.
  • Understanding these variations is essential for consistent patient management.

Purpose of the Study:

  • To investigate the variability in the number of reported axillary lymph nodes in breast cancer patients.
  • To determine factors influencing the number of reported nodes.
  • To assess the impact of reported node count on axillary nodal stage and treatment implications.

Main Methods:

  • Retrospective analysis of 4,806 axillary dissections for invasive breast cancers (1994-1997) in North-Netherlands.

Related Experiment Videos

  • Examined factors associated with reported node counts.
  • Correlated node counts with nodal status and number of positive nodes.

    • Main Results:

    • Significant variation in median reported lymph nodes (9-15) between pathology labs and hospitals (8-15).
    • Higher reported node counts correlated with increased detection of positive nodes (28% <6 nodes to 54% >/=20 nodes).
    • Increased number of positive nodes (>/=4) rose from 4% to 31% with higher node examination.

    Conclusions:

    • Substantial inter-hospital variability exists in reporting axillary lymph nodes.
    • More thorough examination increases positive node identification, impacting staging.
    • Potential for misclassification in adjuvant treatment, particularly regional radiotherapy, due to inconsistent nodal staging.