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Article

Regional Lymph Node Metastasis and Axillary Surgery of Microinvasive Breast Cancer: A Population-Based Study

by
Jiamei Chen
1,†,
Bo Luo
2,†,
Mengting Gao
3,†,
Gaoke Cai
1,
Xixi Luo
1,
Yutian Zhang-Cai
1,
Shaobo Ke
1,* and
Yongshun Chen
1,*
1
Center of Oncology, Renmin Hospital of Wuhan University, Wuhan 430060, China
2
Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
3
Center of Information, Renmin Hospital of Wuhan University, Wuhan 430060, China
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Diagnostics 2022, 12(5), 1049; https://doi.org/10.3390/diagnostics12051049
Submission received: 14 March 2022 / Revised: 15 April 2022 / Accepted: 18 April 2022 / Published: 21 April 2022
(This article belongs to the Section Pathology and Molecular Diagnostics)
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Abstract

Microinvasive breast cancer (MBC for short) is a rare entity with the decision of axillary surgery under debate in clinical practice. We aimed to unravel the lymph node metastasis (LNM) rate, axillary surgery, and prognosis of MBC based on 11,692 patients derived from the Surveillance Epidemiology and End Results (SEER) database between 2003 and 2015. In this retrospective study, 19.5% (2276/11,692) of patients received axillary lymph node dissection (ALND), 80.5% (9416/11,692) received non-ALND. In the total cohort, 10-year breast cancer-specific survival (BCSS) was 96.3%, and the LNM rate was 6.4% (754/11,692). Multivariate analyses showed that LNM had the strongest predictive weight (N3, HR 14.200, 95% CI 7.933–25.417; N2, HR 12.945, 95% CI 7.725–21.694; N1, HR 3.05, 95% CI 2.246–4.140, all p < 0.001). Kaplan–Meier analyses showed that ALND did not confer a survival benefit on 10-year BCS in patients with N0 (94.7% vs. 97.1%, p < 0.001) and in patients with 1–2 positive nodes (92.1% vs. 89.5%, p = 0.355), respectively, when compared to non-ALND. Our study demonstrated that the vast majority of MBC have a low LNM rate and excellent prognosis; patients with LNM showed poor prognosis. Assessment of lymph node status is necessary, and non-ALND surgery is required and sufficient for MBC with 0–2 positive nodes.
Keywords: microinvasive breast cancer; lymph node metastasis; axillary surgery; axillary lymph node dissection; Surveillance Epidemiology and End Results microinvasive breast cancer; lymph node metastasis; axillary surgery; axillary lymph node dissection; Surveillance Epidemiology and End Results

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MDPI and ACS Style

Chen, J.; Luo, B.; Gao, M.; Cai, G.; Luo, X.; Zhang-Cai, Y.; Ke, S.; Chen, Y. Regional Lymph Node Metastasis and Axillary Surgery of Microinvasive Breast Cancer: A Population-Based Study. Diagnostics 2022, 12, 1049. https://doi.org/10.3390/diagnostics12051049

AMA Style

Chen J, Luo B, Gao M, Cai G, Luo X, Zhang-Cai Y, Ke S, Chen Y. Regional Lymph Node Metastasis and Axillary Surgery of Microinvasive Breast Cancer: A Population-Based Study. Diagnostics. 2022; 12(5):1049. https://doi.org/10.3390/diagnostics12051049

Chicago/Turabian Style

Chen, Jiamei, Bo Luo, Mengting Gao, Gaoke Cai, Xixi Luo, Yutian Zhang-Cai, Shaobo Ke, and Yongshun Chen. 2022. "Regional Lymph Node Metastasis and Axillary Surgery of Microinvasive Breast Cancer: A Population-Based Study" Diagnostics 12, no. 5: 1049. https://doi.org/10.3390/diagnostics12051049

APA Style

Chen, J., Luo, B., Gao, M., Cai, G., Luo, X., Zhang-Cai, Y., Ke, S., & Chen, Y. (2022). Regional Lymph Node Metastasis and Axillary Surgery of Microinvasive Breast Cancer: A Population-Based Study. Diagnostics, 12(5), 1049. https://doi.org/10.3390/diagnostics12051049

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