56P Predictors of Axillary Lymph Node Metastases in Women with Breast Cancer

Abstract

ABSTRACT Purpose To assess the impact of different clinical and pathological factors on axillary lymph node involvement in breast cancer patients. Methods A retrospective study of 163 breast cancer patients treated in Ulyanovsk Regional Oncology Center between 2008 and 2010. All the patients received surgery (BCS/mastectomy + axillary lymph node dissection). Clinical factors assessed were: patient's age and tumor localization. Pathological factors: traditional pathological criteria (tumor size, histological variant, grade, HR- and Her-2/neu status) and new total pathological index (Ulyanovsk prognostic index - UPI), introduced by pathologists of our center. UPI is total score of six pathological criteria: degree of cellular differentiation, cellular polymorphism, mitotic activity, growth pattern, LVI, stromal reaction. In accordance with the total score all carcinomas were divided into four groups: 1.Carcinomas of very low malignant potential (UPI scores of 4-6); 2.Low malignant potential (7-10); 3.Moderate malignant potential (11-15); 4.High malignant potential (16-20). Results The median age of the patients was 58.4 ± 11.4 years and the median tumor size was 2.6 ± 1.1 cm. Most of the carcinomas were ER+ (69.3%) and PR+ (65.0%) and Her-2/neu - (82.8%). Of the total 163 breast cancer patients 70 (42.9%) were node positive. Univariative regression analysis revealed that only tumor size (p = 0.03) and UPI (p = 0.00004) are the most powerful predictors of axillary lymph node involvement. There was a lower, but significant association (p = 0.06) between tumor grade and nodal status. Patient's age (p = 0.12), tumor localization (p = 0.79), tumor histology (p = 0.18), ER (p = 0.63), PR (p = 0.52), Her-2/neu status (p = 0.43) had no statistically association with axillary lymph node metastases. Conclusions Tumor size and Ulyanovsk prognostic index are independent prognostic factors for the presence of node metastases. UPI has the highest predictive value, defining malignant potential of the tumor. Disclosure All authors have declared no conflicts of interest.