Non-invasive predictors of axillary lymph node burden in breast cancer: a single-institution retrospective analysis

Ngai, V ORCID: https://orcid.org/0000-0002-6515-1227, Tai, JCJ, Taj, S, Khanfar, H, Sfakianakis, E, Bakalis, A, Ahmed, M and Baker, RD ORCID: https://orcid.org/0000-0003-3555-3425 2022, 'Non-invasive predictors of axillary lymph node burden in breast cancer: a single-institution retrospective analysis' , Breast Cancer Research and Treatment, 195 (2) , pp. 161-169.

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Abstract

Purpose: Axillary staging is an important prognostic factor in breast cancer. Sentinel lymph node biopsy (SNB) is currently used to stage patients who are clinically and radiologically node-negative. Since the establishment that axillary node clearance (ANC) does not improve overall survival in breast-conserving surgery for patients with low-risk biological cancers, axillary management has become increasingly conservative. This study aims to identify and assess the clinical predictive value of variables that could play a role in the quantification of axillary burden, including the accuracy of quantifying abnormal axillary nodes on ultrasound. Methods: A retrospective analysis was conducted of hospital data for female breast cancer patients receiving an ANC at our centre between January 2018 and January 2020. The reference standard for axillary burden was surgical histology following SNB and ANC, allowing categorisation of the patients under ‘low axillary burden’ (2 or fewer pathological macrometastases) or ‘high axillary burden’ (> 2). After exploratory univariate analysis, multivariate logistic regression was conducted to determine relationships between the outcome category and candidate predictor variables: patient age at diagnosis, tumour focality, tumour size on ultrasound and number of abnormal lymph nodes on axillary ultrasound. Results: One hundred and thirty-five patients were included in the analysis. Logistic regression showed that the number of abnormal lymph nodes on axillary ultrasound was the strongest predictor of axillary burden and statistically significant (P = 0.044), with a sensitivity of 66.7% and specificity of 86.8% (P = 0.011). Conclusion: Identifying the number of abnormal lymph nodes on preoperative ultrasound can help to quantify axillary nodal burden and identify patients with high axillary burden, and should be documented as standard in axillary ultrasound reports of patients with breast cancer.

Item Type: Article
Schools: Schools > Salford Business School
Journal or Publication Title: Breast Cancer Research and Treatment
Publisher: Springer US
ISSN: 1573-7217
SWORD Depositor: Publications Router
Depositing User: Publications Router
Date Deposited: 06 Sep 2022 09:28
Last Modified: 06 Sep 2022 09:30
URI: http://usir.salford.ac.uk/id/eprint/64564

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