Predictive values of axillary involvement in breast cancer

In breast cancer, recommendations for axillary surgery are currently shifting toward omitting SLNB. Studies have shown that not performing axillary staging has no impact on regional control or survival and translates into improved quality of life. We sought to determine whether certain clinical factors such as tumor size or type, immunohistochemical characteristics, tumor grade or Ki 67 value are predictive of metastatic disease in the lymph nodes.

A retrospective observational study was conducted of patients who underwent breast cancer surgery during the years 2019-2024. Inclusion criteria were: tumor size equal to or less than 2 cm as measured by ultrasound, and axilla that was clinically and ultrasound-negative.

One hundred and fifty-six breasts were operated on, with a mean age of 64.5 years. Regarding immunohistochemistry, tumor grade, and age, no differences were observed. However, patients with tumors >2 cm and lobular tumors did have greater lymph node involvement (P < .05).

There are no variables that predict lymph node involvement before surgery. Today, we are not prepared to lose the information provided by SLNB, and part of the postoperative treatment is determined by its results.