Predictive Factors of Axillary Lymph Node Metastasis in Breast Cancer
Yodying Wasuthit MD*, Youwanush Kongdan MD*, Ronnarat Suvikapakornkul MD*, Panuwat Lertsithichai MD*, Prakasit Chirappapha MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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.
Keywords : Axillary lymph node metastasis, Predictive factors
