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Clinical and pathologic factors predicting axillary lymph node involvement in breast cancer

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Abstract

The diagnosis of axillary disease remains a challenge in the management of breast cancer and is a subject of controversy. In 1998, the Japanese Breast Cancer Society conducted a study assessing axillary lymph node involvement in breast cancer. The study included (a) clinical assessment by preoperative imaging modalities, (b) histologic assessment for peritumoral lymphatic invasion, (c) biologic assessment by gelatinolytic activity using film in situ zymography, and (d) sentinel lymph node (SLN) biopsy. Clinical assessments by CT, PET, and US as well as biologic assessment were limited in their ability to detect axillary lymph node disease, although these imaging techniques may be useful to exclude node-positive patients from the need for SLN biopsy. Histologic assessment for peritumoral lymphatic invasion was useful, particularly for detecting false-negative cases by SLN biopsy. Never-theless, the utility of SLN biopsy in assessing axillary nodal status was confirmed. Axillary lymph node dissection (ALND) can be avoided in patients with a small tumor and a negative SLN. However, further studies will be required to investigate the value of SLN biopsy for predicting regional control and survival before it can replace routine ALND as the optimal staging procedure for operable breast cancer.

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Abbreviations

SLN:

Sentinel lymph node

ALND:

Axillary lymph node dissection

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Authors and Affiliations

  1. Operation Center Department of Surgery (II), Kanazawa University Hospital, Japan

    Masakuni Noguchi

  2. Operation Center Department of Surgery (II), Kanazawa University Hospital, Japan

    Masakuni Noguchi & Koichiro Tsugawa

  3. Division of Pathology, Saitama Cancer Center, Japan

    Masafumi Kurosumi

  4. Division of Breast Surgery, Aichi Cancer Center, Japan

    Hiroji Iwata

  5. Division of Breast Surgery, Chiba Cancer Center, Japan

    Mitsuru Miyauchi

  6. Department of Surgery, Tokai University, Japan

    Masatoshi Ohta

  7. Division of Breast Surgery, National Cancer Center Hospital East, Japan

    Shigeru Imoto

  8. Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan

    Kazuyoshi Motomura

  9. Department of Surgery (I), National Defense Medical College, Japan

    Kazuhiko Sato

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  1. Masakuni Noguchi
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  2. Masafumi Kurosumi
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  3. Hiroji Iwata
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  4. Mitsuru Miyauchi
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  5. Masatoshi Ohta
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  8. Kazuhiko Sato
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  9. Koichiro Tsugawa
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Noguchi, M., Kurosumi, M., Iwata, H. et al. Clinical and pathologic factors predicting axillary lymph node involvement in breast cancer. Breast Cancer 7, 114–123 (2000). https://doi.org/10.1007/BF02967442

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  • DOI: https://doi.org/10.1007/BF02967442

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