title: Breast cancer sagittal/horizontal plane location influences axillary lymph node involvement.
abstract: OBJECTIVE
  To assess the influence of tumour location on axillary lymph node involvement (ALNI) and prognosis in breast cancer by evaluating the significance of the sagittal/horizontal alignment.
  
  
  METHODS
  We compared 57 patients with superficially located breast carcinomas up to 3.0 cm with patients having lesions in posterior planes of the breast. Both groups were matched according to age, time of diagnosis, tumour size, grade, hormonal receptor status and tumour site within the frontal plane. Histologic evidence of skin involvement, excluding tumours fulfilling the criteria for pT4b, was defined as inclusion criteria and reference plane for superficial tumour location.
  
  
  RESULTS
  Tumours situated in the superficial region of the breast, compared to those located in deeper planes, have an increased risk of ALNI (p=0.023), whereas no difference was observed with reference to disease-specific survival (p=0.203).
  
  
  CONCLUSIONS
  This study shows that ALNI is dependent on sagittal/horizontal as well as frontal tumour location. Clinicians should be aware that tumours lying posteriorly may be at increased risk of occult spread outside axillary lymph nodes.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Spitalstrasse 21, CH-4031 Basel, Switzerland. ugueth@uhbs.ch
authors.forename: U
authors.initials: U
authors.lastname: Güth
authors.forename: E
authors.initials: E
authors.lastname: Wight
authors.forename: I
authors.initials: I
authors.lastname: Langer
authors.forename: A
authors.initials: A
authors.lastname: Schötzau
authors.forename: H
authors.initials: H
authors.lastname: Dieterich
authors.forename: L
authors.initials: L
authors.lastname: Herberich
authors.forename: W
authors.initials: W
authors.lastname: Holzgreve
authors.forename: G
authors.initials: G
authors.lastname: Singer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000556:secondary*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies