Predictive factors of axillary lymph node metastasis in breast cancer

Abstract

Objective: To identify clinical, radiologic and pathologic factors significantly related to axillary lymph node (ALN) metastasis in women with operable breast cancer. Material and Method: Records of women with operable invasive breast cancer treated between July 2002 and May 2006 were reviewed. Data on the number of axillary nodes, number of positive nodes, preoperative clinical, mammographic, and pathologic characteristics of each breast cancer were retrieved. Multiple logistic regression analyses were used to identify significant predictors of ALN metastasis. Results: Records of 590 patients were reviewed. Positive ALNs were found in 302 patients (51%). Independent and significant predictors of ALN metastasis included younger age, larger tumor size, presence of lymphovascular invasion, category 5 mammograms and low mammographic breast density. The combination of age less than 60 years, low mammographic breast density, category 5 mammogram, tumor larger 1 cm., and presence of lymphovascular invasion, had a specificity for predicting ALN metastasis of over 95%. Conclusion: A combination of clinical, radiologic, and pathologic characteristics highly specific for predicting ALN metastasis was found. This prediction rule might be useful for selecting breast cancer patients for full ALN dissection without a preliminary SLNB.