Breast cancer sagittal/horizontal plane location influences axillary lymph node involvement

Area of Science:

• Oncology
• Radiology
• Surgical Pathology

Background:

• Axillary lymph node involvement (ALNI) is a critical prognostic factor in breast cancer.
• Tumour location within the breast may influence lymphatic spread.
• The sagittal/horizontal alignment of breast tumours requires further investigation regarding its impact on ALNI.

Purpose of the Study:

• To evaluate the effect of tumour location, specifically sagittal/horizontal alignment, on axillary lymph node involvement (ALNI) in breast cancer.
• To determine the prognostic significance of tumour location in relation to ALNI and disease-specific survival.

Main Methods:

• A comparative study involving 57 patients with superficial breast carcinomas (≤3.0 cm) and patients with posterior breast lesions.
• Groups were matched for age, diagnosis time, tumour size, grade, hormonal status, and frontal plane location.
• Inclusion criteria: histologic skin involvement, excluding pT4b tumours; superficial location defined by reference plane.

Main Results:

• Superficial breast tumours showed a significantly increased risk of ALNI compared to deeper tumours (p=0.023).
• No significant difference in disease-specific survival was observed between superficial and deeper tumour groups (p=0.203).

Conclusions:

• Breast cancer axillary lymph node involvement is influenced by both sagittal/horizontal and frontal tumour location.
• Posteriorly located breast tumours may carry a higher risk of occult spread beyond the axillary lymph nodes.
• Clinicians should consider tumour location when assessing the risk of lymph node metastasis.