Mammographic characterization of breast cancer associated with axillary lymph node metastasis

Abstract

ObjectiveTo describe mammographic characterization of breast cancer associated with axillary lymph node metastasis at King Chulalongkorn Memorial Hospital. MethodsThe data were collected retrospectively from female patients with breast cancers who underwent breast surgery and axillary node dissection at King Chulalongkorn Memorial Hospital during January 1, 2004 and July 31, 2011. One hundred and ninety histopathologically proven cases of invasive ductal carcinoma (IDC) were randomly recruited; consisted of ninety-five patients with axillary lymph node metastasis and the rest of patients without axillary lymph node metastasis. All patients were reviewed their mammograms with additional ultrasounds and correlation between each mammographic characteristic and ipsilateral node involvement was analyzed, using P-value (P), Odd ratio (OR) and 95% confidence interval (CI). ResultsMammographic characterization associated with the highest risk of axillary node metastasis was malignant pattern of ipsilateral axillary node (P < 0.001; OR = 44.53; 95%CI = 13.10 − 151.37) with following by intermediate pattern of ipsilateral axillary node (P = 0.002; OR=5.18; 95%CI = 1.79 − 15.04). The other characteristics in descending orders for associated with axillary node involvement are upper outer quadrant tumors associated risk of ipsilateral axillary node involvement (P = 0.02; OR = 3.36; 95%CI = 1.23 − 9.14) and size of breast cancer by additional ultrasound (P = 0.04; OR = 1.48; 95%CI = 1.02-2.17). There was no association between risk of axillary node involvement and the rest of mammographic findings, including microcalcification of the tumor, vascularity of the tumor and size of axillary node. ConclusionThe highest predictive risk of axillary node metastasis in breast cancer was malignant axillary node pattern. The moderate risk was intermediate axillary node pattern and the lower risks were the tumor located in upper outer quadrant and increased tumor size. These results will be helpful for diagnostic mammogram to imply prognosis of breast cancer before patient undergo biopsy or surgical procedure.