Journal des essais cliniques
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Abstrait

Nodal Positive Breast Cancer and its Regional Lymph Node Involvement

Heidrun Männle*, Matthias Frank, Felix Momm, Jan Willem Siebers

Objective: In breast cancer, the lymph node status is of prognostic importance and a decisive factor in therapy planning. This study shows the distribution of lymph nodes metastases of node-positive breast cancer patients. Risk factors for lymph node metastases are described.

Methods: 2095 patients with primary breast cancer were analyzed. Analysis included descriptive analysis (median, standard deviation, ranges) and statistical analysis (Chi2 , discriminant analysis).

Results: The nodal stage was positive in 39.4% of all patients and negative in 60.6%. If the nodal stage was positive, only 1 lymph node was involved in 36% of the patients; more than 1 lymph node was involved in 64% of the patients. With an increasing number of lymph node metastases in level I, the probability of an involvement in level III also increases (F 437.845, p=.000). Other indicators are evidence of hemangiosis (F 247.728, p=.000) or lymphangiosis (F 167.368, P=.000). Despite <10 affected lymph nodes, 3.4% of the patients had nodal stage N3 due to level III involvement.

Conclusion: Even with only a small number of lymph node metastases in level-I higher lymphatic stations are often affected. The data cannot lead to a decision regarding an operation or radiation indication, but they can better substantiate the risk for certain therapy decisions.