Axillary nodal involvement by primary tumor features in early breast cancer: an analysis of 2600 patients. Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Primary tumor characteristics, which are readily available to all clinicians, may aid in selecting the optimal adjuvant therapy for patients with breast cancer (BC). Herein, we investigated the relationship between tumor size, hormone receptor and HER2 status, Ki67 and age with axillary lymph node metastases (ALNM) in early-BC patients. METHODS: We analyzed data on consecutive 2600 early-BC cases collected in the registry of Fondazione IRCC Istituto Nazionale dei Tumori, Milano, Italy. Correlation between Ki67 and primary tumor size (T-size) was calculated by Spearman's rank correlation coefficient. Association of ALNM with Ki67 and other tumor characteristics was investigated by logistic regression. Adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) were estimated in all cases, and separately analyzed according to age, T-size and BC subtype. RESULTS: Large tumor size strongly associated to ALNM, with an adjusted odds ratio (OR) for each 5-mm increase of 1.32 (95% CI 1.24-1.41), except for triple-negative BC (TNBC) cases. In tumors =10 mm, without lymphovascular invasion, representing the strongest predictor of ALNM (OR 6.09, 95% CI 4.93-7.53), Ki67 resulted particularly informative, with a fourfold increased odds of ALNM for values > 30%. CONCLUSIONS: These results raise the question whether axillary node status is redundant in cases with exceptionally good features, i.e., small tumors with low Ki67, or in those candidate to adjuvant systemic treatment/radiotherapy anyway including TNBC, and support the incorporation of primary BC tumor characteristics as stratification factors in ongoing trials aiming at de-escalating axillary surgical procedures.
Original languageEnglish
Pages (from-to)786-792
Number of pages7
JournalClinical and Translational Oncology
Volume22
Issue number5
DOIs
Publication statusPublished - 2020

Keywords

  • Female
  • Humans
  • Middle Aged
  • Aged
  • Lymphatic Metastasis
  • Tumor Burden
  • Logistic Models
  • Odds Ratio
  • Breast cancer
  • Axillary node metastases
  • Ki67
  • Primary tumor features
  • Italy/epidemiology
  • Biomarkers, Tumor/metabolism
  • Predictive Value of Tests
  • Receptor, ErbB-2/metabolism
  • Ki-67 Antigen/metabolism
  • Axilla
  • Breast Neoplasms/epidemiology/*pathology/surgery
  • Lymph Nodes/*pathology/surgery
  • Receptors, Steroid/metabolism

Fingerprint

Dive into the research topics of 'Axillary nodal involvement by primary tumor features in early breast cancer: an analysis of 2600 patients. Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico'. Together they form a unique fingerprint.

Cite this