부산대학교 도서관

Aims: To determine whether primary tumour characteristics of breast cancer — size, histological type, grade, vascular invasion (VI) and receptor status (ER) correlate with axillary nodal involvement. Can we select a group of breast cancer patients in whom axillary surgery can be safely avoided? Methods: A retrospective analysis of 1496 patients with breast cancer presenting between 1986 and 2001 was carried out. All patients had been treated by wide local excision/mastectomy as well as an axillary four-node sample/level-III clearance. Results: Five hundred and sixty (37.4 per cent) out of a total 1496 patients had metastases in axillary nodes. The following table shows the lymph node (LN) involvement compared with size, grade and VI. Univariate analysis showed VI [Pearson Chi-square (pcs): 128.1; df: 2; P < 0.0001], size [pcs: 106.8; df: 4; P < 0.0001], grade [pcs: 39.9; df: 2; P < 0.0001] and ER status [pcs: 9.5; df: 2; P < 0.009] to correlate positively with positive LN status in decreasing order of strength. However, multivariate analysis showed that only VI and size independently predict LN positivity. Even tumours less than 5 mm had nodal involvement in over 10 per cent of cases. Only those tumours less than 4.5 mm diameter were free of nodal metastases (n = 22). Conclusions: Although axillary LN involvement correlated positively with size and vascular invasion, it would be unwise to presume negative axillary node status in any subgroup of invasive breast cancer. [ABSTRACT FROM AUTHOR]