Lymph node metastases in early breast cancer

Lymph node metastases in early breast cancer

Lymph Node Metastases in Early Breast Cancer

Increased use of screening mammography has led to more frequent detection of breast cancer at stages when the primary tumor is very small. In addition, surgical techniques have increasingly emphasized conservation of breast tissue. Thus, the ability to predict whether patients with small tumors require axillary lymph node dissection has become increasingly important.

To determine factors associated with axilliary node metastasis, Reger and associates reviewed 626 cases of breast cancer in which the tumor was 2 cm or less in diameter. The factors considered were the patient’s age, estrogen receptor status of the tumor, tumor location, the degree of histologic differentiation and tumor size.

Only tumor size was significantly associated with axillary lymph node metastasis. The percentage of cases with involved nodes rose from 3 percent for tumors less than 0.5 cm in diameter to 35 percent when primary tumors measured between 1.6 cm and 2 cm. The degree of tumor differentiation was weakly associated with the incidence of axillary node metastasis. Patient age, tumor location and estrogen receptor status were not found to correlate with the incidence of axillary node metastasis.

The findings of this review support the belief that axillary lymph node metastases are extremely rare in patients with small, noninvasive breast cancers. Since current mammographic techniques can detect tumors as small as 3 mm, the authors emphasize the importance of screening mammography for the detection of early breast cancer. (American Journal of Surgery, May 1989, vol. 157, p. 501.)

COPYRIGHT 1989 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group