Kędzierawski Piotr, Bocian Artur, Radowicz-Chil Agnieszka, Huruk-Kuchinka Anna, Mężyk Ryszard
Department of Radiotherapy, Holycross Cancer Centre, Kielce, Poland.
The Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland.
Arch Med Sci. 2020 Sep 23;19(3):618-625. doi: 10.5114/aoms.2019.88595. eCollection 2023.
The purpose of the study was to determine the correlation between biological subtype of breast cancer and the risk of its metastasis to a sentinel lymph node.
In the analysed group there were 1018 women with breast cancer, clinically node negative, untreated previously. Luminal A subtype was recognised in 57% of patients. A positive sentinel lymph node was detected in 26.5% of women.
In the multivariate analysis only age and tumour size proved to be significant for the entire group, respectively: OR = 0.59, = 0.0004; OR = 1.96; < 0.0001. For Luminal A subtype values were OR = 0.51, = 0.0007; OR = 1.78, = 0.0045, respectively. For Luminal B patients, in women over 61 years, the risk of sentinel node metastasis probability decreases by 67% and for tumours over 21 mm the probability of positive sentinel node metastasis increases by 117%.
According to our analysis luminal breast cancers are most numerous subtypes, and in these cases we expect more frequent instances of metastasis to a sentinel node. Following the most updated and modern procedures of breast cancer patients' treatment a procedure of sentinel lymph node biopsy is used, replacing an aggressive treatment in the axilla region. In regards to our analysis we should be more vigilant in estimation of regional lymph nodes in luminal patients under sixty with high grade tumours and the tumour diameter more than 20 mm.
本研究的目的是确定乳腺癌的生物学亚型与其转移至前哨淋巴结风险之间的相关性。
分析组中有1018例未经治疗的临床淋巴结阴性乳腺癌女性患者。57%的患者被诊断为Luminal A亚型。26.5%的女性检测到前哨淋巴结阳性。
在多因素分析中，仅年龄和肿瘤大小对整个组具有显著意义，分别为：OR = 0.59，P = 0.0004；OR = 1.96，P < 0.0001。对于Luminal A亚型，值分别为OR = 0.51，P = 0.0007；OR = 1.78，P = 0.0045。对于Luminal B患者，61岁以上女性前哨淋巴结转移概率风险降低67%，对于直径超过21 mm的肿瘤，前哨淋巴结转移阳性概率增加117%。
根据我们的分析，管腔型乳腺癌是最常见的亚型，在这些病例中，我们预计前哨淋巴结转移的情况更频繁。遵循最新和现代的乳腺癌患者治疗程序，采用前哨淋巴结活检程序，取代腋窝区域的激进治疗。就我们的分析而言，对于60岁以下、肿瘤分级高且肿瘤直径超过20 mm的管腔型患者，我们在评估区域淋巴结时应更加警惕。
