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. 2021 Jan 11:13:215-223.
doi: 10.2147/CMAR.S284922. eCollection 2021.

Predictive Factors Among Clinicopathological Characteristics for Sentinel Lymph Node Metastasis in T1-T2 Breast Cancer

Shigeki Minami  1 , Chika Sakimura  1 , Junji Irie  2 , Yukiko Tokai  3 , Hitoshi Okubo  4 , Tsuyoshi Ohno  5
Affiliations

Predictive Factors Among Clinicopathological Characteristics for Sentinel Lymph Node Metastasis in T1-T2 Breast Cancer

Shigeki Minami et al. Cancer Manag Res. .

Abstract

Background: The axillary lymph node status is an important prognostic factor of breast cancer. This study explores the predictive factors for sentinel lymph node (SLN) metastasis among the preoperative clinicopathological features, including impaired glucose tolerance (IGT).

Methods: This study comprised patients diagnosed with breast cancer who underwent surgery at Nagasaki Harbor Medical Center between April 2014 and December 2019. The factors assessed using univariate and multivariate analyses were the clinicopathological data of these cancers, including the patient age, gender, menstrual status, breast or ovarian cancer family history, body mass index, glycosylated hemoglobin, clinical tumor size, nipple-tumor distance (NTD), tumor histology, histological grade, node status, estrogen receptor, progesterone receptor, human epidermal growth factor receptor type 2 status, and Ki67 labeling index.

Results: In the cohort of 313 cases, the ratio of SLN metastasis was 17.3%. A univariate analysis found that the tumor size, NTD, IGT, and clinical tumor stage were associated with SLN metastasis. In a multivariable analysis, the tumor size, NTD, and IGT were associated with SLN metastasis. The receiver operating characteristic curve showed a sensitivity and specificity of 61.1% and 65.6%, respectively, at a cut-off of 1.7 cm for the tumor size (area under the curve [AUC]: 0.664; 95% confidence interval: 0.592-0.736), and a sensitivity and specificity of 60.4% and 62.9%, respectively, at a cut-off of 2.0 cm for NTD (AUC: 0.651; 95% confidence interval: 0.571-0.731) to predict the risk of SLN metastasis.

Conclusion: T1 and T2 breast cancer patients with a larger tumor size, tumor located closer to the nipple, and IGT have a higher risk of SLN metastases than others.

Keywords: breast cancer; impaired glucose tolerance; nipple-tumor distance; predictive factor; sentinel lymph node metastasis.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
(A and B) Box plot showing the differences in tumor size and distance from the nipple between the node-positive and node-negative cases (P < 0.001 for both). The bottom and top edges of the box are drawn at the 25th and 75th percentiles, respectively. The center horizontal line is drawn at the 50th percentile (median).
Figure 2
Figure 2
(A and B) ROC curve analyses for determining the cut-off points of the tumor size and distance from the nipple for the node-positive and node-negative cases. (A) Tumor size (cut-off=1.7 cm; AUC= 0.664; sensitivity=61.1%; specificity=65.6%) and (B) Distance from the nipple (cut-off=2.0 cm; AUC=0.651; sensitivity=60.4%; specificity=62.9%).
See this image and copyright information in PMC

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