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Updated: Jul 9, 2025
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Optimization of a Multiplex RNA-based Expression Assay Using Breast Cancer Archival Material
Published on: August 1, 2018
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Factors Associated With Node-Positive Disease in Estrogen Receptor-Positive Breast Cancer Patients
Julia Gallagher1, Kelly M Elleson2, Katherine Englander1
1University of South Florida Morsani College of Medicine, Tampa, Florida.
The Journal of Surgical Research
|December 7, 2023
Summary
Tumor size and location impact lymph node involvement in estrogen receptor-positive breast cancer. The relationship varies significantly based on progesterone receptor and HER2 status, affecting metastasis risk.
Area of Science:
- Oncology
- Breast Cancer Research
- Surgical Pathology
Background:
- Lymph node metastasis is a key prognostic factor in breast cancer.
- While tumor size and location are known risk factors, their interplay with specific receptor subtypes and nodal involvement requires further clarification.
Purpose of the Study:
- To investigate the association between primary tumor characteristics (size, location) and lymph node metastasis across different estrogen receptor (ER)-positive breast cancer subtypes.
- To elucidate how progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status modify these associations.
Main Methods:
- Retrospective chart review of 618 ER-positive breast cancer patients diagnosed between 1998-2019.
- Exclusion of specific disease types (e.g., inflammatory, metastatic) and treatments (neoadjuvant chemotherapy).
- Statistical analysis using descriptive statistics, Kruskal-Wallis, and Chi-square/Fisher exact tests to assess relationships between tumor characteristics and nodal status.
Main Results:
- A significant association was found between larger median tumor size and node positivity in ER+/PR+/HER2-, ER+/PR+/HER2+, and ER+/PR-/HER2- subtypes.
- Node-positive patients with ER+/PR+/HER2- tumors had a significantly shorter tumor-to-nipple distance.
- Upper outer quadrant tumor location was linked to higher nodal positivity in the ER+/PR-/HER2- subtype.
Conclusions:
- The relationship between tumor size, location, and lymph node positivity in ER-positive breast cancer is complex and significantly influenced by PR and HER2 receptor status.
- These findings highlight the importance of considering specific molecular subtypes when assessing nodal metastasis risk.
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