Predicting Axillary Nodal Positivity in Patients with Breast Carcinoma Treated at Vajira Hospital
Abstract
Background: The single most significant predictive factor of survival in patients with breast cancer is the absolute number of lymph nodes involved with metastases. The purpose of this study was to estimate the likelihood of axillary lymph node involvement base on a variety of clinical and pathologic factors and determined the nodal positivity, survival and other prognostic factors.
Methods: All patients with breast cancer treated at Breast Clinic, Vajira Hospital from January 1994 through December 2001 who underwent modified radical mastectomy or axillary lymph node dissection as part of their treatment were evaluated.
Results: Of 204 breast cancer patients the axillary node metastases is 86 (42.2%). The axillary node metastases in nonpalpable tumor is 5 of 40 (12.5%) and palpable tumor is 81 of 164 (49.4%). The nonpalpable tumors have smaller size than palpable tumors, they are less likely to have positive axillary nodes (p 0.000) and less likely to have lymphatic vascular invasion (p 0.05). Nonpalpable tumors have a better survival than palpable tumor (p 0.0217).
Conclusions: For the breast cancer patients, the axillary lymph node metastases are positively correlated with tumor size, the axillary nodal status is the most significant predictive factor of survival. Nonpalpable tumors are more likely to be smaller and their nodal positivity is lower.
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