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Higher risk tumor features are not associated with higher nodal stage in patients with estrogen receptor-positive, node-positive breast cancer.

Publication ,  Journal Article
Ye, L; Rünger, D; Angarita, SA; Hadaya, J; Baker, JL; Lee, MK; Thompson, CK; Attai, DJ; DiNome, ML
Published in: Breast Cancer Res Treat
June 2022

INTRODUCTION: Studies support omission of axillary lymph node dissection (ALND) for patients with sentinel node-positive disease, with ALND recommended for patients who present with clinically positive nodes. Here, we evaluate patient and tumor characteristics and pathologic nodal stage of patients with estrogen receptor-positive (ER +) breast cancer who undergo ALND to determine if differences exist based on nodal presentation. MATERIALS AND METHODS: Retrospective chart review from 2010 to 2019 defined three groups of patients with ER + breast cancer who underwent ALND for positive nodes: SLN + (positive node identified at SLN biopsy), cNUS (abnormal preoperative US and biopsy), and cNpalp (palpable adenopathy). Patients who received neoadjuvant chemotherapy or presented with axillary recurrence were excluded. RESULTS: Of 191 patients, 94 were SLN + , 40 were cNUS, and 57 were cNpalp. Patients with SLN + compared with cNpalp were younger (56 vs 64 years, p < 0.01), more often pre-menopausal (41% vs 14%, p < 0.01), and White (65% vs 39%, p = 0.01) with more tumors that were low-grade (36% vs 8%, p < 0.01). Rates of PR + (p = 0.16), levels of Ki67 expression (p = 0.07) and LVI (p = 0.06) did not differ significantly among groups. Of patients with SLN + disease, 64% had pN1 disease compared to 38% of cNUS (p = 0.1) and 40% of cNpalp (p = 0.01). On univariable analysis, tumor size (p = 0.01) and histology (p = 0.04) were significantly associated with pN1 disease, with size remaining an independent predictor on multivariable analysis (p = 0.02). CONCLUSION: Historically, higher risk features have been attributed to patients with clinically positive nodes precluding omission of ALND, but when restricting evaluation to patients with ER + breast cancer, only tumor size is associated with higher nodal stage.

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Published In

Breast Cancer Res Treat

DOI

EISSN

1573-7217

Publication Date

June 2022

Volume

193

Issue

2

Start / End Page

429 / 436

Location

Netherlands

Related Subject Headings

  • Sentinel Lymph Node Biopsy
  • Retrospective Studies
  • Receptors, Estrogen
  • Oncology & Carcinogenesis
  • Lymphatic Metastasis
  • Lymph Node Excision
  • Humans
  • Female
  • Breast Neoplasms
  • Axilla
 

Citation

APA
Chicago
ICMJE
MLA
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Ye, L., Rünger, D., Angarita, S. A., Hadaya, J., Baker, J. L., Lee, M. K., … DiNome, M. L. (2022). Higher risk tumor features are not associated with higher nodal stage in patients with estrogen receptor-positive, node-positive breast cancer. Breast Cancer Res Treat, 193(2), 429–436. https://doi.org/10.1007/s10549-022-06581-9
Ye, Linda, Dennis Rünger, Stephanie A. Angarita, Joseph Hadaya, Jennifer L. Baker, Minna K. Lee, Carlie K. Thompson, Deanna J. Attai, and Maggie L. DiNome. “Higher risk tumor features are not associated with higher nodal stage in patients with estrogen receptor-positive, node-positive breast cancer.Breast Cancer Res Treat 193, no. 2 (June 2022): 429–36. https://doi.org/10.1007/s10549-022-06581-9.
Ye L, Rünger D, Angarita SA, Hadaya J, Baker JL, Lee MK, et al. Higher risk tumor features are not associated with higher nodal stage in patients with estrogen receptor-positive, node-positive breast cancer. Breast Cancer Res Treat. 2022 Jun;193(2):429–36.
Ye, Linda, et al. “Higher risk tumor features are not associated with higher nodal stage in patients with estrogen receptor-positive, node-positive breast cancer.Breast Cancer Res Treat, vol. 193, no. 2, June 2022, pp. 429–36. Pubmed, doi:10.1007/s10549-022-06581-9.
Ye L, Rünger D, Angarita SA, Hadaya J, Baker JL, Lee MK, Thompson CK, Attai DJ, DiNome ML. Higher risk tumor features are not associated with higher nodal stage in patients with estrogen receptor-positive, node-positive breast cancer. Breast Cancer Res Treat. 2022 Jun;193(2):429–436.
Journal cover image

Published In

Breast Cancer Res Treat

DOI

EISSN

1573-7217

Publication Date

June 2022

Volume

193

Issue

2

Start / End Page

429 / 436

Location

Netherlands

Related Subject Headings

  • Sentinel Lymph Node Biopsy
  • Retrospective Studies
  • Receptors, Estrogen
  • Oncology & Carcinogenesis
  • Lymphatic Metastasis
  • Lymph Node Excision
  • Humans
  • Female
  • Breast Neoplasms
  • Axilla