Prognostic Value of Extracapsular Invasion of Axillary Lymph Nodes Combined with Peritumoral Vascular Invasion in Patients with Breast Cancer

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• 作者：Reina Yajima MD (1)
  Takaaki Fujii MD ; PhD (1)
  Yasuhiro Yanagita MD ; PhD (2)
  Tomomi Fujisawa MD ; PhD (2)
  Takeshi Miyamoto MD ; PhD (2)
  Tomoko Hirakata MD ; PhD (2)
  Soichi Tsutsumi MD ; PhD (1)
  Misa Iijima MD ; PhD (3)
  Hiroyuki Kuwano MD ; PhD (1)
  
  1. Department of General Surgical Science ; Graduate School of Medicine ; Gunma University ; Maebashi ; Gunma ; Japan
  2. Department of Breast Oncology ; Gunma Prefectural Cancer Center ; Ota ; Gunma ; Japan
  3. Department of Pathology ; Gunma Prefectural Cancer Center ; Ota ; Gunma ; Japan
  
• 刊名：Annals of Surgical Oncology
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：22
• 期：1
• 页码：52-58
• 全文大小：307 KB
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• 刊物主题：Surgical Oncology; Oncology; Surgery;
• 出版者：Springer US
• ISSN：1534-4681

文摘

Background Extracapsular invasion (ECI) of metastatic axillary lymph nodes has been associated with aggressive nodal disease but its prognostic role in breast cancer is unclear. The present study evaluated nodal ECI as a predictor of breast cancer recurrence. Methods We evaluated 154 women with histologically proven node-positive breast cancer who were diagnosed with invasive ductal carcinoma, and investigated the relationships between ECI and recurrences and other clinicopathological factors, particularly vascular invasion and the number of lymph node metastases. Results The presence of ECI at positive nodes was significantly associated with the number of positive nodes, and with disease recurrence and survival in univariate (but not multivariate) analysis. Interestingly, all ECI+ patients with distant metastases in our series had peritumoral vascular invasion (PVI), which may have reflected systemic disease; ECI with PVI of the primary tumor strongly predicted recurrent disease and shorter survival. Conclusion ECI of axillary metastases combined with PVI indicates high tumor aggressiveness. Patients with ECI and PVI may be considered for stronger adjuvant therapies because of their high risk for distant recurrences.