European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026
Axillary nodal burden and preoperative predictors in biopsy-proven node-positive breast cancer undergoing upfront surgery.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lee Chi Hoon, Kim Kibeom, Byun Dahn, Nam Seok Jin, Kim Seok Won, Lee Jeong Eon, Yu Jonghan, Chae Byung Joo, Lee Se Kyung, Park Woong Ki, Jung Ji-Jung, Ryu Jai Min
Аннотация
INTRODUCTION: Recent trials support omitting axillary lymph node dissection (ALND) in selected sentinel node-positive patients, but those with preoperative biopsy-proven nodal metastasis remain underrepresented. We characterized axillary nodal burden and its preoperative predictors.
MATERIALS AND METHODS: We retrospectively studied patients with cT1-3 breast cancer and biopsy-proven axillary metastasis who underwent upfront ALND between 2008 and 2023 with at least one positive node. Nodal burden was classified as limited (1-2 positive nodes) or extensive (≥3). Multivariable logistic regression identified predictors.
RESULTS: Among 1671 patients (median 21 nodes retrieved), 662 (39.6%) had limited and 1009 (60.4%) had extensive nodal burden. Suspicious node count on axillary ultrasound (AUS) was independently associated with extensive burden (two nodes: OR 2.26, 95% CI 1.64-3.12; ≥3 nodes: OR 2.08, 1.67-2.59; both p < 0.001), as was higher clinical T stage (cT2: OR 1.35, p = 0.009; cT3: OR 1.57, p = 0.008). Extensive burden ranged from 41.0% (cT1, one suspicious node) to 75.0% (cT3, two suspicious nodes). The AUS ≥3 and AUS 2 groups did not differ for ≥3 positive nodes but differed for ≥10 positive nodes (24.8% vs. 14.0%). Among 574 patients with a non-palpable axilla, AUS remained associated with extensive burden whereas clinical T stage did not.
CONCLUSION: Extensive nodal burden was common yet heterogeneous. AUS suspicious node count and clinical T stage were associated with extensive disease, but discrimination was modest. These findings do not support uniform omission of ALND and require prospective validation.
MATERIALS AND METHODS: We retrospectively studied patients with cT1-3 breast cancer and biopsy-proven axillary metastasis who underwent upfront ALND between 2008 and 2023 with at least one positive node. Nodal burden was classified as limited (1-2 positive nodes) or extensive (≥3). Multivariable logistic regression identified predictors.
RESULTS: Among 1671 patients (median 21 nodes retrieved), 662 (39.6%) had limited and 1009 (60.4%) had extensive nodal burden. Suspicious node count on axillary ultrasound (AUS) was independently associated with extensive burden (two nodes: OR 2.26, 95% CI 1.64-3.12; ≥3 nodes: OR 2.08, 1.67-2.59; both p < 0.001), as was higher clinical T stage (cT2: OR 1.35, p = 0.009; cT3: OR 1.57, p = 0.008). Extensive burden ranged from 41.0% (cT1, one suspicious node) to 75.0% (cT3, two suspicious nodes). The AUS ≥3 and AUS 2 groups did not differ for ≥3 positive nodes but differed for ≥10 positive nodes (24.8% vs. 14.0%). Among 574 patients with a non-palpable axilla, AUS remained associated with extensive burden whereas clinical T stage did not.
CONCLUSION: Extensive nodal burden was common yet heterogeneous. AUS suspicious node count and clinical T stage were associated with extensive disease, but discrimination was modest. These findings do not support uniform omission of ALND and require prospective validation.