Low incidence of lymph node metastasis in patients with microinvasive breast cancer: a Korean nationwide study

Pill Sun Paik; Nam Sun Paik; Eun Sook Lee; Jung Eun Choi; Joon Jeong; Hyun Jo Youn; Chang Ik Yoon; Soo Youn Bae; Tae-Kyung Yoo; Korean Breast Cancer Society

Low incidence of lymph node metastasis in patients with microinvasive breast cancer: a Korean nationwide study

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Type: Academic journal

Author: Pill Sun Paik (Bucheon St. Mary’s Hospital) Nam Sun Paik (Ewha Womans University) Eun Sook Lee (National Cancer Center Goyang) Jung Eun Choi (Yeungnam University College of Medicine) Joon Jeong (Yonsei University College of Medicine) Hyun Jo Youn (Jeonbuk National University Medical School)

Journal: The Korean Surgical Society Annals of Surgical Treatment and Research Vol.102 No.6 KCI Accredited Journals SCIE

Published: 2022.6

Pages: 306 - 312 (7page)

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Low incidence of lymph node metastasis in patients with microinvasive breast cancer: a Korean nationwide study

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Purpose: Microinvasive breast cancer (MIBC) is an invasive carcinoma with a tumor dimension not exceeding 1 mm. Owing to its low incidence, the rate of axillary node metastasis and its management are not well established. The aim of this study was to assess the incidence of lymph node metastasis (LNM) and identify variables associated with LNM, as well as to evaluate the need for axillary staging in MIBC patients by analyzing nationwide data.
Methods: The Korean Breast Cancer Society registry was searched to identify MIBC patients diagnosed between January 1996 and April 2020. Patients without neoadjuvant chemotherapy experiences, systemic metastasis, and missing or discordant data were eligible for the analysis. The incidence rate of LNM was determined, and variables associated with LNM were identified by multivariable regression analysis.
Results: Of 2,427 MIBC patients identified, 98 (4.0%) had LNM and 12 (0.5%) had N2/3 disease. Type of breast operation (odds ratio [OR], 2.093; 95% confidence interval [CI], 1.332–3.290; P = 0.001), age (OR, 2.091; 95% CI, 1.326–3.298; P = 0.002), hormone receptor status (OR, 2.220; 95% CI, 1.372–3.594; P = 0.001), and lymphovascular invasion (OR, 11.143; 95% CI, 6.354–19.540; P < 0.001) were significantly related to LNM.
Conclusion: The incidence of LNM in MIBC patients was only 4.0% in our study, suggesting that de-escalation of axillary surgical interventions could be carefully considered. The indications for axillary staging should be individualized considering tumor volume, age, hormone receptor status, and lymphovascular invasion to improve the quality of life of MIBC survivors.

#Axilla #Breast neoplasms #Lymphatic metastasis #Microinvasive #Sentinel lymph node biopsy

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