Journal of the Korean Cancer Association 1999;31(6): 1179-1187.
Axillary Lymph Node Metastases in Patients with T1 Breast Carcinoma: Correlation with Histopathologic and Immunohistochemical Characteristics of the Primary Tumor
1Department of Neurology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea. 2Department of Internal Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea. 3Department of Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea. 4Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea. 5Department of Diagnostic Pathology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea. 6Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 7Department of Diagnostic Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
ABSTRACT
PURPOSE: Axillary lymph node metastases (ALNM) are the most important prognostic indicator in breast carcinoma. Because of relatively low incidence of axillary metastasis in the patients with Tl breast carcinoma, axillary lymph node dissection is now no longer considered to be the standard treatment. A reliable prediction of ALNM.may reduce the need for axillary lymph node dissection and may facilitate to select appropriate treatment modality. We have attempted to identify histopathologic/immunohistochemical factors correlated with ALNM in the patients with Tl breast carcinoma.
MATERIAL AND METHODS: Forty-one patients with Tl breast carcinoma who underwent modified radical mastectomy and axillary dissection between January 1993 and February 1999 were studied. We investigated the relationship between ALNM and the histopathologic/immunohistochemical factors (size, lymphatic-vascular invasion (LVI), histologic grade, age, estrogen receptor (ER) status, progesterone receptor (PR) status, p53 protein, cathepsin D (CD), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), transforming growth factor (TGF)- B 2, and microvessel density (MVD)).
RESULTS: Fourteen (34.2%) out of the 41 patients with Tl breast carcinoma had ALNM. There are five statistically significant factors correlated with ALNM; lymphatic-vascular invasion (P=0.002), histologic grade (P 0.047), immunohistochemical expression of CD (P=0.005) and TGF- B 2 (P=0.004), and microvessel density (P=0.002).
CONCLUSION: The histopathologic/immunohistochemical features of the primary breast tumor, such as LVI, increase in MVD, TGF- B 2 and CD expression, and histologic grade might be useful predictors of ALNM in patients with Tl breast carcinoma.
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