Extra-nodal extension is a significant prognostic factor in lymph node positive breast cancer
| Autor: | Ying Chen, Lars A. Akslen, Benedicte Davidsen, Elisabeth Wik, Hans Aas, Sura Mohammed Aziz, Tor Audun Klingen, Gøril Knutsvik, Turid Aas |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Oncology Cancer Treatment lcsh:Medicine Kaplan-Meier Estimate Metastasis 0302 clinical medicine Mathematical and Statistical Techniques Breast Tumors Basic Cancer Research Medicine and Health Sciences Artikkel Prospective Studies Prospective cohort study lcsh:Science Lymph node education.field_of_study Multidisciplinary Middle Aged Prognosis Primary tumor medicine.anatomical_structure Research Design 030220 oncology & carcinogenesis Lymphatic Metastasis Physical Sciences Female Lymph Anatomy Statistics (Mathematics) Research Article medicine.medical_specialty Histology Clinical Research Design Population Breast Neoplasms Research and Analysis Methods Disease-Free Survival Lymphatic System 03 medical and health sciences Breast cancer Medisinske Fag: 700 [VDP] Internal medicine Breast Cancer medicine Humans VDP::Medisinske Fag: 700 Statistical Methods education Survival analysis Aged Proportional Hazards Models business.industry lcsh:R Cancers and Neoplasms Biology and Life Sciences medicine.disease Survival Analysis 030104 developmental biology Metastatic Tumors Multivariate Analysis lcsh:Q Lymph Nodes Neoplasm Grading business Mathematics |
| Zdroj: | PLoS ONE PLoS ONE, Vol 12, Iss 2, p e0171853 (2017) |
| Popis: | Presence of lymph node (LN) metastasis is a strong prognostic factor in breast cancer, whereas the importance of extra-nodal extension and other nodal tumor features have not yet been fully recognized. Here, we examined microscopic features of lymph node metastases and their prognostic value in a population-based cohort of node positive breast cancer (n = 218), as part of the prospective Norwegian Breast Cancer Screening Program NBCSP (1996–2009). Sections were reviewed for the largest metastatic tumor diameter (TD-MET), nodal afferent and efferent vascular invasion (AVI and EVI), extra-nodal extension (ENE), number of ENE foci, as well as circumferential (CD-ENE) and perpendicular (PD-ENE) diameter of extra-nodal growth. Number of positive lymph nodes, EVI, and PD-ENE were significantly increased with larger primary tumor (PT) diameter. Univariate survival analysis showed that several features of nodal metastases were associated with disease-free (DFS) or breast cancer specific survival (BCSS). Multivariate analysis demonstrated an independent prognostic value of PD-ENE (with 3 mm as cut-off value) in predicting DFS and BCSS, along with number of positive nodes and histologic grade of the primary tumor (for DFS: P = 0.01, P = 0.02, P = 0.01, respectively; for BCSS: P = 0.02, P = 0.008, P = 0.02, respectively). To conclude, the extent of ENE by its perpendicular diameter was independently prognostic and should be considered in line with nodal tumor burden in treatment decisions of node positive breast cancer. |
| Databáze: | OpenAIRE |
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