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Axillary node status in nonpalpable breast cancer
K Dowlatshahi1, H C Snider, R Kim
1Department of General Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA.
Annals of Surgical Oncology
|September 1, 1995
Summary
Tumor size in nonpalpable breast cancers accurately predicts axillary node metastasis. Mammogram and pathology specimen measurements correlate with the likelihood of cancer spread to lymph nodes.
Area of Science:
- Oncology
- Radiology
- Pathology
Background:
- Axillary lymph node status is crucial for breast cancer prognosis.
- Its role in managing nonpalpable tumors remains debated.
- This study investigates the correlation between primary tumor size and lymph node metastasis in nonpalpable breast cancers.
Purpose of the Study:
- To determine if primary tumor size predicts axillary lymph node metastasis in nonpalpable breast cancers.
- To correlate tumor size, measured by mammography and pathology, with the incidence of positive axillary nodes.
Main Methods:
- Retrospective analysis of 241 breast cancer cases (220 invasive, 21 microinvasive) treated with needle localization and axillary dissection.
- Tumor size was categorized based on mammographic and pathological findings.
- Invasive cancers included mass lesions (n=166) and microcalcifications alone (n=54).
Main Results:
- Axillary metastases were detected in 9% of cancers presenting as microcalcifications alone.
- For mass lesions, metastasis rates were 0%, 11%, and 22% based on mammographic size groups (<5mm, 6-10mm, 11-20mm).
- Pathology-based size measurements showed metastasis rates of 5%, 10%, and 27% for corresponding size groups.
Conclusions:
- Tumor size, whether measured by mammogram or on the excised pathology specimen, is a reliable predictor of axillary lymph node metastasis.
- These findings support the use of tumor size in assessing the risk of nodal spread for nonpalpable breast cancers.