title: Predictive factors of axillary lymph node metastasis in breast cancer.
abstract: OBJECTIVE
  To identify clinical, radiologic and pathologic factors significantly related to axillary lymph node (ALN) metastasis in women with operable breast cancer.
  
  
  METHODS
  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%.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Yodying
authors.initials: Y
authors.lastname: Wasuthit
authors.forename: Youwanush
authors.initials: Y
authors.lastname: Kongdan
authors.forename: Ronnarat
authors.initials: R
authors.lastname: Suvikapakornkul
authors.forename: Panuwat
authors.initials: P
authors.lastname: Lertsithichai
authors.forename: Prakasit
authors.initials: P
authors.lastname: Chirappapha
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008327:Mammography; D008499:Medical Records; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy