Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
BMC Med Imaging. 2024 May 14;24(1):108. doi: 10.1186/s12880-024-01290-9.
The purpose of this research is to study the sonographic and clinicopathologic characteristics that associate with axillary lymph node metastasis (ALNM) for pure mucinous carcinoma of breast (PMBC).
A total of 176 patients diagnosed as PMBC after surgery were included. According to the status of axillary lymph nodes, all patients were classified into ALNM group (n = 15) and non-ALNM group (n = 161). The clinical factors (patient age, tumor size, location), molecular biomarkers (ER, PR, HER2 and Ki-67) and sonographic features (shape, orientation, margin, echo pattern, posterior acoustic pattern and vascularity) between two groups were analyzed to unclose the clinicopathologic and ultrasonographic characteristics in PMBC with ALNM.
The incidence of axillary lymph node metastasis was 8.5% in this study. Tumors located in the outer side of the breast (upper outer quadrant and lower outer quadrant) were more likely to have lymphatic metastasis, and the difference between the two group was significantly (86.7% vs. 60.3%, P = 0.043). ALNM not associated with age (P = 0.437). Although tumor size not associated with ALNM(P = 0.418), the tumor size in ALNM group (32.3 ± 32.7 mm) was bigger than non-ALNM group (25.2 ± 12.8 mm). All the tumors expressed progesterone receptor (PR) positively, and 90% of all expressed estrogen receptor (ER) positively, human epidermal growth factor receptor 2 (HER2) were positive in two cases of non-ALNM group. Ki-67 high expression was observed in 36 tumors in our study (20.5%), and it was higher in ALNM group than non-ALNM group (33.3% vs. 19.3%), but the difference wasn't significantly (P = 0.338).
Tumor location is a significant factor for ALNM in PMBC. Outer side location is more easily for ALNM. With the bigger size and/or Ki-67 higher expression status, the lymphatic metastasis seems more likely to present.
本研究旨在探讨与乳腺单纯黏液癌（PMBC）腋窝淋巴结转移（ALNM）相关的超声及临床病理特征。
共纳入术后诊断为 PMBC 的 176 例患者。根据腋窝淋巴结状态，所有患者分为 ALNM 组（n=15）和非 ALNM 组（n=161）。分析两组间临床因素（患者年龄、肿瘤大小、位置）、分子标志物（ER、PR、HER2、Ki-67）和超声特征（形态、方位、边界、回声模式、后方声影模式、血流），以揭示 PMBC 伴 ALNM 的临床病理及超声特征。
本研究中，ALNM 的发生率为 8.5%。位于乳房外侧（外上象限和外下象限）的肿瘤更易发生淋巴转移，两组间差异有统计学意义（86.7%比 60.3%，P=0.043）。ALNM 与年龄无关（P=0.437）。尽管肿瘤大小与 ALNM 无关（P=0.418），但 ALNM 组的肿瘤大小（32.3±32.7mm）大于非 ALNM 组（25.2±12.8mm）。所有肿瘤孕激素受体（PR）均阳性表达，雌激素受体（ER）阳性表达率均为 90%，非 ALNM 组中有 2 例 HER2 阳性。本研究中 36 例（20.5%）肿瘤 Ki-67 高表达，ALNM 组高于非 ALNM 组（33.3%比 19.3%），但差异无统计学意义（P=0.338）。
肿瘤位置是 PMBC 发生 ALNM 的重要因素。外侧位置更易发生 ALNM。随着肿瘤体积增大和/或 Ki-67 高表达，更易发生淋巴转移。
