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Title   2 cm 이하의 유방암에서 액와 림프절 전이 인자 ( The Predictors of Axillary Node Metastasis in 2 cm or Less Breast Cancer )
Publicationinfo   1999 Jan; 031(06): 1188-1195.
Key_word   Breast cancer, Lymph node, Prognosis, Tl stage
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Abstract   Purpose: Axillary node involvement is the single most important prognostic variable in patients with breast cancer. If axillary lymph node status of breast cancer patients could be accurately predicted from basic clinical information and from characteristics of their primary tumors, many patients could be spared axillary lymph node dissection. With the availability of numerous histologic prognosticators and new immunochemical prognostic indicators, it is reasonable to reconsider the necessity of axillary node dissection for lesions more advanced than duct carcinoma in situ. Materials and Methods: Six hundred fifty-six patients with Tl invasive breast cancer were evaluated. All the patients underwent axillary dissection, and the pathologic status of the nodes was known. The parameters of the primary tumor in this study were age, size, family history, tumor palpability, nuclear and histological grade, hormone receptor status, lymphatic vessel invasion (LVI), and various tumor markers (bc1-2, cathepsinD, c-erbB2, E-cadherin, p53). Results: Approximately 31% of the 656 patients with Tl breast carcinoma had axillary node metastasis. Four factors were identified as significant predictors of node metastasis: age 35 or less (p=0.01), lymphatic vessel invasion (p < 0.01), tumor palpability (p=0.02), and tumor size (p<0.01). However, independent predictors of lymph node metastasis in the multivariate logistic regression analyses were tumor size (p=0.04) and LVI (p=0.03). Conclusion: Characteristics of the primary tumor can help assess the risk for axillary lymph node metastases in Tl breast cancer. Selected patients who have 1cm or less without lymphatic vessel invasion are considered to be at minimal risk of axillary node metastasis and might be spared routine axillary dissection.
저 자   강한성(Han Sung Kang),노동영(Dong Young Noh),권오중(Oh Joong Kwon),윤여규(Yeo Kyu Youn),오승근(Seung Keun Oh),최국진(Kuk Jin Choe)