title: Criteria for prediction of metastatic axillary lymph nodes in early-stage breast cancer.
abstract: OBJECTIVE
  To estimate the likelihood of axillary lymph node involvement for patients with early-stage breast cancer, based on a variety of clinical and pathological factors.
  
  
  METHODS
  A retrospective analysis was done in hospital databases from 1999 to 2007. Two hundred thirty-nine patients were diagnosed with early-stage breast cancer. Predictive factors, such as patient age, tumor size, lymphovascular invasion, histological grade and immunohistochemical subtype were analyzed to identify variables that may be associated with axillary lymph node metastasis.
  
  
  RESULTS
  Patients with tumors that are negative for estrogen receptor, progesterone receptor, and HER2 had approximately a 90% lower chance of developing lymph node metastasis than those with luminal A tumors (e.g., ER+ and/or PR+ and HER2-) - Odds Ratio: 0.11; 95% confidence interval: 0.01-0.88; p=0.01. Furthermore, the risk for lymph node metastasis of luminal A tumors seemed to decrease as patient age increased, and it was directly correlated with tumor size.
  
  
  CONCLUSIONS
  The molecular classification of early-stage breast cancer using immunohistochemistry may help predicting the probability of developing axillary lymph node metastasis. Further studies are needed to optimize predictions for nodal involvement, with the aim of aiding the decision-making process for breast cancer treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Helio Rubens
authors.initials: HR
authors.lastname: de Oliveira Filho
authors.affiliation: Department of Obstetrics and Gynecology, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Maíra Teixeira
authors.initials: MT
authors.lastname: Dória
authors.affiliation: Department of Obstetrics and Gynecology, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: José Roberto Morales
authors.initials: JR
authors.lastname: Piato
authors.affiliation: Department of Obstetrics and Gynecology, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: José Maria
authors.initials: JM
authors.lastname: Soares Junior
authors.affiliation: Department of Obstetrics and Gynecology, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: José Roberto
authors.initials: JR
authors.lastname: Filassi
authors.affiliation: Department of Obstetrics and Gynecology, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Edmund Chada
authors.initials: EC
authors.lastname: Baracat
authors.affiliation: Department of Obstetrics and Gynecology, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Marcos Desidério
authors.initials: MD
authors.lastname: Ricci
mesh_terms: D000328:Adult; D001365:Axilla; D001943:Breast Neoplasms / Q000145:classification / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies