Concurrent finding of Breast cancer and axillary Lymph nodes in Receptor Positive Patients

Abstract

Background and Objectives: The most frequent site of disease involvement in breast cancer that has progressed from the initial lesion is the axillary lymph nodes (ALN). There are still no reliable ways to anticipate ALN status prior to surgery, despite sentinel node biopsy being a reliable means of managing ALN. Materials and Methods: This was a retrospective study of female patients with invasive breast cancer at Tertiary care hospital between January 2020 and January 2023. The clinical data and tumor character­istics for all invasive breast cancers (425) had been collected in breast cancer database. This study was approved by the institu­tional review board and ethics committee. Breast cancer patients who had undergone surgery were identified. The exclusion criteria were: 1) ductal carcinoma in situ; 2) neoadjuvant therapy; 3) bilateral invasive breast cancer; and 4) patients without breast-conserving surgery with ALND or sentinel lymph node sampling or modified radical mastectomy. SVM was used for analysis. Results: Of these, 242 patients had positive ALNM. The mean tumor size was 24.4 mm (SD=1.5); 38% of the patients had T1 tumors (＜20 mm), followed by 52% with T2 tumors and 10% with T3 tumors. The histology grade was predominantly grade II (57%), with 28% grade III and 15% grade I tumors. Lymph vascular invasion was found in 200 patients (47%). The ER/PR/HER2 profile showed 270 patients (63.5%) had luminal A type tumors, followed by 16.5% with triple-negative tumors, 13.1% with luminal B type tumors, and 6.9% with HER2-positive tumors. A higher AUC value indicated a better diagnostic perfor­mance. The AUC value of this study was 0.754 by SVM. Conclusion: It is possible to forecast ALN status using a model that is just dependent on clinically common pathologic data derived from the source tumor. This could support the surgeon's decision-making for ALN management and breast cancer counseling.