title: Predictors of axillary lymph node metastases (ALNM) in a Korean population with T1-2 breast carcinoma: triple negative breast cancer has a high incidence of ALNM irrespective of the tumor size.
abstract: OBJECTIVE
  We estimated the likelihood of breast cancer patients having axillary lymph node metastases (ALNM) based on a variety of clinical and pathologic factors.
  
  
  METHODS
  Three hundred sixty-one breast cancer patients without distant metastases and who underwent breast conserving surgery and axillary lymph node dissection (ALND) (level I and II) or modified radical mastectomy (MRM) were identified, and we retrospectively reviewed their pathology records and treatment charts.
  
  
  RESULTS
  Positive axillary lymph nodes were detected in 104 patients for an overall incidence of 28.8%: 2 patients (5%) with T1a tumor, 5 (9.2%) with T1b tumor, 24 (21.8%) with T1c tumor and 73 (44.2%) with T2 tumor. On the multivariate analysis, an increased tumor size (adjusted OR=11.87, p=0.02), the presence of lymphovascular invasion (adjusted OR=7.41, p<0.01), a triple negative profile (ER/PR-, Her2-) (adjusted OR=2.09, p=0.04) and a palpable mass at the time of diagnosis (adjusted OR=2.31, p=0.03) were all significant independent factors for positive ALNM.
  
  
  CONCLUSIONS
  In our study, the tumor size, the presence of lymphovascular invasion, a triple negative profile and a palpable mass were the independent predictive factors for ALNM. The tumor size was the strongest predictor of ALNM. Thus, the exact estimation of the extent of tumor is necessary for clinicians to optimize the patients' care. Patients with a triple negative profile have a high incidence of ALNM irrespective of the tumor size.
authors.affiliation: Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University College of Medicine, Suwon, Korea.
authors.forename: Jong Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Sung Hwan
authors.initials: SH
authors.lastname: Kim
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Suh
authors.forename: Byoung Yong
authors.initials: BY
authors.lastname: Shim
authors.forename: Hoon Kyo
authors.initials: HK
authors.lastname: Kim