title: Axillary lymph node status in multicentric breast tumors and breast tumors with nipple involvement.
abstract: BACKGROUND
  Axillary lymph node dissection plays an important role in breast cancer management in terms of staging, prediction of prognosis, determination of adjuvant therapy, and local control of the primary tumor. The objective of this study was to evaluate the axillary lymph node involvement in multicentric breast tumors and breast tumors with nipple involvement in comparison with unifocal tumors.
  
  
  METHODS
  We reviewed the records of 267 patients with stage I or IIA disease. The rates of axillary lymph node metastasis (ALNM) in patients with unifocal tumors, multicentric tumors, or nipple involvement were compared.
  
  
  RESULTS
  209 (78%) patients had unifocal tumors, 24 (8%) had multicentric tumors, and 34 (12%) had nipple involvement. The incidence of ALNM was 9.76% in patients with unifocal tumors, 24.84% in patients with multicentric tumors, and 36.71% in patients with nipple involvement. Hence, the incidence of ALNM was significantly higher in patients with nipple involvement or multicentric tumors than in patients with unifocal tumors.
  
  
  CONCLUSIONS
  Our data suggest that compared to unifocal tumors, breast tumors with nipple involvement or multiple foci show a significantly higher incidence of ALNM which is a predictor of a poor prognosis.
authors.affiliation: Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Cakir
authors.affiliation: Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Tekin
authors.affiliation: Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey.
authors.forename: Tevfik
authors.initials: T
authors.lastname: Kücükkartallar
authors.affiliation: Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey.
authors.forename: Celalettin
authors.initials: C
authors.lastname: Vatansev
authors.affiliation: Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Aksoy
authors.affiliation: Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey.
authors.forename: Adil
authors.initials: A
authors.lastname: Kartal
authors.affiliation: Department of General Surgery, Meram Medical Faculty, Selcuk University, Konya, Turkey.
authors.forename: Fatma B
authors.initials: FB
authors.lastname: Tuncer
keywords: Axillary lymph nodes; Breast cancer: multicentric, nipple involvement