Antonio Marrazzo1, Giovanni Boscaino2, Emilia Marrazzo3, Pietra Taormina4, Antonio Toesca5. 1. Department of Surgical, Oncological and Stomatological Sciences, Policlinico Hospital "Paolo Giaccone", University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy. Electronic address: antonio.marrazzo@unipa.it. 2. Department of Economics, Business and Statistics Sciences, University of Palermo, Viale delle Scienze, 90128 Palermo, Italy. 3. Department of Surgical, Oncological and Stomatological Sciences, Policlinico Hospital "Paolo Giaccone", University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy. Electronic address: emilia.marrazzo@hotmail.it. 4. Breast Unit, Clinic "Macchiarella", Viale Regina Margherita, 25, 90138 Palermo, Italy. 5. Division of Breast Surgery, European Institute of Oncology, Via Giuseppe Ripamonti, 435, 20141 Milan, Italy. Electronic address: antonio.toesca@ieo.it.
Abstract
INTRODUCTION: The need for performing axillary lymph-node dissection in early breast cancer when the sentinel lymph node (SLN) is positive has been questioned in recent years. The purpose of this study was to identify a low-risk subgroup of early breast cancer patients in whom surgical axillary staging could be avoided, and to assess the probability of having a positive lymph-node (LN). METHODS: We evaluated the cohort of 612 consecutive women affected by early breast cancer. We considered age, tumor size, histological grade, vascular invasion, lymphatic invasion and cancer subtype (Luminal A, Luminal B HER-2+, Luminal B HER-2-, HER-2+, and Triple Negative) as variables for univariate and multivariate analyses to assess probability of there being a positive SLN o nonsentinel lymph node (NSLN). Chi-square, Fisher's Exact test and Student's t tests were used to investigate the relationship between variables; whereas logit models were used to estimate and quantify the strength of the relationship among some covariates and SLN or the number of metastases. RESULTS: A significant positive effect of vascular invasion and lymphatic invasion (odds ratios are 4 and 6), and a negative effect of TN (odds ratios is 10) were noted. With respect to positive NSLN, size alone has a significant (positive) effect on tumor presence, but focusing on the number of metastases, also age has a (negative) significant effect. CONCLUSION: This work shows correlation between subtypes and the probability of having positive SLN. Patients not expressing vascular invasion, lymphatic invasion and, moreover, a triple-negative tumor subtype may be good candidates for breast conservative surgery without axillary surgical staging.
INTRODUCTION: The need for performing axillary lymph-node dissection in early breast cancer when the sentinel lymph node (SLN) is positive has been questioned in recent years. The purpose of this study was to identify a low-risk subgroup of early breast cancerpatients in whom surgical axillary staging could be avoided, and to assess the probability of having a positive lymph-node (LN). METHODS: We evaluated the cohort of 612 consecutive women affected by early breast cancer. We considered age, tumor size, histological grade, vascular invasion, lymphatic invasion and cancer subtype (Luminal A, Luminal B HER-2+, Luminal B HER-2-, HER-2+, and Triple Negative) as variables for univariate and multivariate analyses to assess probability of there being a positive SLN o nonsentinel lymph node (NSLN). Chi-square, Fisher's Exact test and Student's t tests were used to investigate the relationship between variables; whereas logit models were used to estimate and quantify the strength of the relationship among some covariates and SLN or the number of metastases. RESULTS: A significant positive effect of vascular invasion and lymphatic invasion (odds ratios are 4 and 6), and a negative effect of TN (odds ratios is 10) were noted. With respect to positive NSLN, size alone has a significant (positive) effect on tumor presence, but focusing on the number of metastases, also age has a (negative) significant effect. CONCLUSION: This work shows correlation between subtypes and the probability of having positive SLN. Patients not expressing vascular invasion, lymphatic invasion and, moreover, a triple-negative tumor subtype may be good candidates for breast conservative surgery without axillary surgical staging.
Authors: Luciana Marques Paula; Luis Henrique Ferreira De Moraes; Abaeté Leite Do Canto; Laurita Dos Santos; Airton Abrahão Martin; Silvia Regina Rogatto; Renata De Azevedo Canevari Journal: Oncol Lett Date: 2016-11-28 Impact factor: 2.967
Authors: Emilia Marrazzo; Federico Frusone; Flavio Milana; Andrea Sagona; Wolfgang Gatzemeier; Erika Barbieri; Alberto Bottini; Giuseppe Canavese; Arianna Olga Rubino; Marco Gaetano Eboli; Carlo Marco Rossetti; Alberto Testori; Valentina Errico; Alessandro De Luca; Corrado Tinterri Journal: Breast Date: 2019-11-11 Impact factor: 4.380