Clinical breast cancer · 2026
Breast Cancer Location Predicts Sentinel Lymph Node Metastasis in Clinically Node Negative Patients With Invasive Breast Cancer Treated With Upfront Surgery.
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Riaz Nazia, AbuOddus Nizar, Peturson Hafsteinn, Wärnberg Fredrik, Olofsson Bagge Roger
Аннотация
BACKGROUND: Assessment of clinicopathological factors is standard for predicting the sentinel lymph node (SLN) status in patients with clinically node negative breast cancer. Limited studies have specifically addressed the value of cancer location as an independent factor predicting SLN status. This study aimed to evaluate whether clinicopathological factors, and specifically cancer location, predict SLN status.
METHODS: This retrospective study was performed in a cohort of consecutive patients diagnosed with T1 to T3 clinically node negative invasive breast cancer managed at a single institution between 2003 and 2008. All underwent SLN biopsy as part of their primary surgery. Multivariable logistic regression was performed to assess the value of clinicopathological factors, including tumor location, for predicting SLN metastasis.
RESULTS: A total of 1231 patients were included with a median age of 60 years and median tumor size of 19 mm. The majority (78%) of tumors were estrogen receptor positive. SLN was positive in 17.6% patients. Multivariable logistic regression showed that age (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.97-1.00; P = .03), tumor size (OR 1.04, 95% 1.03-1.05; P < .001), and location, specifically inferior-lateral (OR 0.40, 95% CI 0.20-0.84; P = .01), and superior-medial (OR 0.54, 95% CI 0.31-0.97; P = .04) quadrant, were factors significantly associated with SLN status.
CONCLUSION: Tumor location within the breast was an independent risk factor for SLN metastasis. Therefore, considering cancer location in addition to standard clinicopathological factors can be an important factor when selecting patients for future de-escalation of axillary surgery.
METHODS: This retrospective study was performed in a cohort of consecutive patients diagnosed with T1 to T3 clinically node negative invasive breast cancer managed at a single institution between 2003 and 2008. All underwent SLN biopsy as part of their primary surgery. Multivariable logistic regression was performed to assess the value of clinicopathological factors, including tumor location, for predicting SLN metastasis.
RESULTS: A total of 1231 patients were included with a median age of 60 years and median tumor size of 19 mm. The majority (78%) of tumors were estrogen receptor positive. SLN was positive in 17.6% patients. Multivariable logistic regression showed that age (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.97-1.00; P = .03), tumor size (OR 1.04, 95% 1.03-1.05; P < .001), and location, specifically inferior-lateral (OR 0.40, 95% CI 0.20-0.84; P = .01), and superior-medial (OR 0.54, 95% CI 0.31-0.97; P = .04) quadrant, were factors significantly associated with SLN status.
CONCLUSION: Tumor location within the breast was an independent risk factor for SLN metastasis. Therefore, considering cancer location in addition to standard clinicopathological factors can be an important factor when selecting patients for future de-escalation of axillary surgery.