Skip to main content

Advertisement

SpringerLink
Log in

Prognostic Importance of Tumor Deposits in the Ipsilateral Axillary Region of Breast Cancer Patients

  • Original Article
  • Published:
Pathology & Oncology Research

Abstract

Tumor deposits (TD) are irregular discrete tumor masses in adipose tissue, discontinuous from the primary tumor, that are described in various cancers. The incidence and/or prognostic value of TD in breast carcinomas have not been studied so far. We reevaluated 145 breast cancer patients, diagnosed and treated between 2001 and 2006 at our institution for the presence and incidence of TD. Histologic type, grade, size of the primary tumor, estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2 status of the tumor, and presence of peritumoral lymphovascular invasion were included in the data. TD were detected in 42 cases (29.0%). The mean age of the patients was 52.2 years (27–82). Most patients (79.3%) had either invasive carcinoma of no special type (NST) or invasive lobular carcinoma, and most tumors (86.9%) were either grade 2 or 3. After excluding TD from the number of metastatic lymph nodes, the pN status of 9 patients changed. Univariate analysis of 110 patients with follow-up information revealed that the new pN status (p = 0.036), presence of local recurrence (p = 0.016) and TD (p = 0.003) were significantly correlated with distant metastases. The median follow-up of the patients was 84 months (5–161), 10-year disease-free survival and overall survival were 67.2% and 73.7%, respectively. In multivariate analysis, presence of TD remained independently associated with distant metastasis (p = 0.002). The probability of distant metastasis was 3.3 times higher in patients with TD. These results emphasize that TD are present in breast cancer patients, and that their presence should warn the clinician in terms of possible distant metastasis. Therefore, presence of TD, the evaluation of which is neither time consuming nor require sophisticated methods, should be included in pathology reports.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gabriel WB, Dukes C, Bussey HJR (1935) Lymphatic spread in cancer of the rectum. Br J Surg 23:395–413

    Article  Google Scholar 

  2. Puppa G, Ueno H, Kayahara M, Capelli P, Canzonieri V, Colombari R, Maisonneuve P, Pelosi G (2009) Tumor deposits are encountered in advanced colorectal cancer and other adenocarcinomas: an expanded classification with implications for colorectal cancer staging system including a unifying concept of in-transit metastases. Mod Pathol 22:410–415

    Article  CAS  PubMed  Google Scholar 

  3. Sun Z, Wang ZN, Xu YY, Zhu GL, Huang BJ, Xu Y, Liu FN, Zhu Z, Xu HM (2012) Prognostic significance of tumor deposits in gastric cancer patients who underwent radical surgery. Surgery 151:871–881

    Article  PubMed  Google Scholar 

  4. Ersen A, Unlu MS, Akman T, Sagol O, Oztop I, Atila K, Bora S, Ellidokuz H, Sarioglu S (2014) Tumor deposits in gastric carcinomas. Pathol Res Pract 210:565–570

    Article  PubMed  Google Scholar 

  5. Sarioglu S, Akbulut N, Iplikci S, Aydin B, Dogan E, Unlu M, Ellidokuz H, Ada E, Akman F, Ikiz AO (2016) Tumor deposits in head and neck carcinomas. Head Neck 38(Suppl 1):E256–E260

    Article  PubMed  Google Scholar 

  6. Goldstein NS, Turner JR (2000) Pericolonic tumor deposits in patients with T3N+M0 colon adenocarcinomas: markers of reduced disease free survival and intraabdominal metastases and their implications for TNM classification. Cancer 88:2228–2238

    Article  CAS  PubMed  Google Scholar 

  7. Nagtegaal ID, Quirke P (2007) Colorectal tumour deposits in the mesorectum and pericolon: a critical review. Histopathology 51:141–149

    Article  CAS  PubMed  Google Scholar 

  8. Ratto C, Ricci R, Rossi C, Morelli U, Vecchio FM, Doglietto GB (2002) Mesorectal microfoci adversely affect the prognosis of patients with rectal cancer. Dis Colon Rectum 45:733–742

    Article  CAS  PubMed  Google Scholar 

  9. Shimada Y, Takii Y (2010) Clinical impact of mesorectal extranodal cancer tissue in rectal cancer: detailed pathological assessment using whole-mount sections. Dis Colon Rectum 53:771–778

    Article  PubMed  Google Scholar 

  10. Tong LL, Gao P, Wang ZN, Song YX, Xu YY, Sun Z, Xing CZ, Xu HM (2012) Is the seventh edition of the UICC/AJCC TNM staging system reasonable for patients with tumor deposits in colorectal cancer? Ann Surg 255:208–213

    Article  PubMed  Google Scholar 

  11. Ueno H, Mochizuki H (1997) Clinical significance of extrabowel skipped cancer infiltration in rectal cancer. Surg Today 27:617–622

    Article  CAS  PubMed  Google Scholar 

  12. Ueno H, Mochizuki H, Hashiguchi Y, Ishiguro M, Miyoshi M, Kajiwara Y, Sato T, Shimazaki H, Hase K (2007) Extramural cancer deposits without nodal structure in colorectal cancer: optimal categorization for prognostic staging. Am J Clin Pathol 127:287–294

    Article  PubMed  Google Scholar 

  13. Ueno H, Hashiguchi Y, Shimazaki H, Shinto E, Kajiwara Y, Nakanishi K, Kato K, Maekawa K, Nakamura T, Yamamoto J, Hase K (2014) Peritumoral deposits as an adverse prognostic indicator of colorectal cancer. Am J Surg 207:70–77

    Article  PubMed  Google Scholar 

  14. Puppa G, Maisonneuve P, Sonzogni A, Masullo M, Capelli P, Chilosi M, Menestrina F, Viale G, Pelosi G (2007) Pathological assessment of pericolonic tumor deposits in advanced colonic carcinoma: relevance to prognosis and tumor staging. Mod Pathol 20:843–855

    Article  PubMed  Google Scholar 

  15. Hortobagyi GN, Connolly JL, D’Orsi CJ et al (2017) Breast. In: Amin MA (ed) AJCC Cancer staging manual, 8th edn. Springer, pp 589–628

  16. Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ, eds (2012) WHO classification of Tumours of the breast, 4th ed. Lyon, IARC Press

    Google Scholar 

  17. Yamauchi C, Hasebe T, Iwasaki M, Imoto S, Wada N, Fukayama M, Ochiai A (2007) Accurate assessment of lymph vessel tumor emboli in invasive ductal carcinoma of the breast according to tumor areas, and their prognostic significance. Hum Pathol 38:247–259

    Article  PubMed  Google Scholar 

  18. Marinho VF, Metze K, Sanches FS, Rocha GF, Gobbi H (2008) Lymph vascular invasion in invasive mammary carcinomas identified by the endothelial lymphatic marker D2-40 is associated with other indicators of poor prognosis. BMC Cancer 8:64

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Nagtegaal ID, Tot T, Jayne DG, McShane P, Nihlberg A, Marshall HC, Pahlman L, Brown JM, Guillou PJ, Quirke P (2011) Lymph nodes, tumor deposits, and TNM: are we getting better? J Clin Oncol 29:2487–2492

    Article  PubMed  Google Scholar 

  20. Lee HS, Lee HE, Yang HK, Kim WH (2013) Perigastric tumor deposits in primary gastric cancer: implications for patient prognosis and staging. Ann Surg Oncol 20:1604–1613

    Article  PubMed  Google Scholar 

  21. Belt EJ, van Stijn MF, Bril H, de Lange-de Klerk ES, Meijer GA, Meijer S, Stockmann HB (2010) Lymph node negative colorectal cancers with isolated tumor deposits should be classified and treated as stage III. Ann Surg Oncol 17:3203–3211

    Article  PubMed  PubMed Central  Google Scholar 

  22. Song YX, Gao P, Wang ZN, Liang JW, Sun Z, Wang MX, Dong YL, Wang XF, Xu HM (2012) Can the tumor deposits be counted as metastatic lymph nodes in the UICC TNM staging system for colorectal cancer? PLoS One 7:e34087

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Rock JB, Washington MK, Adsay NV, Greenson JK, Montgomery EA, Robert ME, Yantiss RK, Lehman AM, Frankel WL (2014) Debating deposits: an interobserver variability study of lymph nodes and pericolonic tumor deposits in colonic adenocarcinoma. Arch Pathol Lab Med 138:636–642

    Article  PubMed  Google Scholar 

  24. Goldstein NS, Turner JR (2000) Pericolonic tumour deposits in patients with T3N+M0 colon adenocarcinomas: markers of reduced disease free survival and intra-abdominal metastases and their implications for TNM classification. Cancer 88:2228–2238

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Dokuz Eylul University Faculty of Medicine, Inciralti, 35340, Izmir, Turkey

    Merih Guray Durak, Tulay Canda, Betul Yilmaz, Nazli Sena Seker, Seda Eryigit Kokkoz & Sulen Sarioglu

  2. Department of Radiation Oncology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey

    Zumre Arican Alicikus, Nesrin Akturk & Ilknur Bilkay Gorken

  3. Department of Preventive Oncology, Dokuz Eylul University Institute of Oncology, Izmir, Turkey

    Hulya Ellidokuz

  4. Department of General Surgery, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey

    Ali Ibrahim Sevinc & Serdar Saydam

Authors
  1. Merih Guray Durak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tulay Canda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Betul Yilmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nazli Sena Seker
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Seda Eryigit Kokkoz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zumre Arican Alicikus
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nesrin Akturk
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ilknur Bilkay Gorken
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hulya Ellidokuz
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ali Ibrahim Sevinc
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Serdar Saydam
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Sulen Sarioglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Merih Guray Durak.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Durak, M.G., Canda, T., Yilmaz, B. et al. Prognostic Importance of Tumor Deposits in the Ipsilateral Axillary Region of Breast Cancer Patients. Pathol. Oncol. Res. 25, 577–583 (2019). https://doi.org/10.1007/s12253-018-0515-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12253-018-0515-4

Keywords

Search

Navigation