T1 유방암에서 액와림프절전이의 예측

Abstract

PURPOSE: The axillary lymph node status is the most important prognostic factor in breast cancer. The axillary node dissection is usually performed in infiltrating brcast cancer for the information of therapeutic decision and prediction of prognosis. But this procedure may result in lymphedema of affected upper extremity nearly about 25%, increased axillary drainage, sensory abnormality and pain. Many researches are focussed to find the patients group who do not need axillary dissection according to the status of tumor size, patient age, hormonal receptor and histologic grade. MATERIAL AND METHODS: We evaluated the axillary lymph node status in patients with tumor size less than 2 cm in diameter and thein correlation of other prognostic factor. We reviewed 127 women with histologically diagnosed infiltrating ductal carcinoma of breast who were treated by one surgeon at Yongdong Severance Hospital, Yonsei University College of medlcine between 1991 and 1996. RESULTS: Five patients (3.9%) had Tla lesion (<5 mm), 24 patients (18.9%) had Tlb tumors (6-10 mm), and 98 cases (77.2%) had Tlc lesion (11-20 mm). The average numbers of axillary lymph nodes dissected were 14.2. We found that smallcr tumor size, good histologic grade, estrogen receptor positivity, old age (over 50 years) showed a tendency of decreased axillary node metastasis but without statistical significance. CONCLUSION: There are possibility of finding subset with low risk of axillary lymph node metastasis in small sized tumor with addition of good prognostic indicators such as good histologic grade, hormonal receptors and old age.