림프절 전이가 있는 작은 크기의 유방암 환자에서 종양 크기와 환자 예후 및 예후 관련 인자들과의 연관성

한홍석; 유재민; 김이삭; 백현준; 박성민; 배수연; 이세경; 유종한; 이정언; 남석진; 김석원

doi:https://doi.org/10.14449/jbd.2016.4.2.48

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자료유형: 학술저널

저자정보: 한홍석 (성균관대학교 의과대학 삼성서울병원 외과) 유재민 (성균관대학교 의과대학 삼성서울병원 외과) 김이삭 (성균관대학교 의과대학 삼성서울병원 외과) 백현준 (성균관대학교 의과대학 삼성서울병원 외과) 박성민 (성균관대학교 의과대학 삼성서울병원 외과) 배수연 (성균관대학교 의과대학 삼성서울병원 외과) 이세경 (성균관대학교 의과대학 삼성서울병원 외과) 유종한 (성균관대학교 의과대학 삼성서울병원 외과) 이정언 (성균관대학교 의과대학 삼성서울병원 외과) 남석진 (성균관대학교 의과대학 삼성서울병원 외과) 김석원 (성균관대학교 의과대학 삼성서울병원 외과)

저널정보: 한국유방암학회 Journal of Breast Disease Journal of Breast Disease 제4권 제2호

발행연도: 2016.12

수록면: 48 - 57 (10page)

DOI: https://doi.org/10.14449/jbd.2016.4.2.48

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Purpose: Larger tumor size and more extensive lymph node (LN) involvement have been considered independent factors for poor prognosis of breast cancer. We evaluated whether smaller tumor size may be a factor of worse prognosis compared with larger tumor size in small-sized breast cancer with LN involvement. Methods: A retrospective analysis was conducted at a single center for 1,400 patients with small-sized (≤2 cm) and LN involved (N1?N3) breast cancer who underwent radical surgery, had no distant metastases, and were diagnosed between 2004 and 2014. We subdivided their tumor size into four subgroups (T1mi, T1a, T1b, T1c) graded using the 7th American Joint Committee on Cancer staging and two subgroups (T1ab [≤1 cm] and T1c [>1 cm]) divided by tumor size. The relationship between tumor size, prognosis and specific features were analyzed using the Chi-square test, Kaplan-Meier method, and Cox regression analysis. Results: There were significant differences in estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (HER2) and HER2 amplified type among the four subgroups in all patients. Especially, HER2-amplified type also appeared in distribution significantly between the two subgroups in all patients (T1ab [13.0%] vs. T1c [8.0%], p=0.008). The overall survival of the T1N1 staged patients in the smaller-sized tumor group (T1ab) was lower than that of those in the larger-sized group (T1c) (p=0.005). In the multivariate Cox regression analysis of all patients, the T1ab group showed a higher mortality risk compared with the T1c group (adjusted hazard ratio, 2.540; 95% confidence interval, 1.195?5.397; p=0.015). Conclusion: Smaller-sized tumors with LN involvement indicated worse prognosis compared with larger-sized tumors.

#Breast neoplasms #Lymph nodes #Prognosis #Tumor burden

참고문헌 (32)

참고문헌 신청

Fowble BL / 1994 / The influence of young age on outcome in early stage breast cancer / Int J Radiat Oncol Biol Phys 30:23~33

Slamon DJ / 1987 / Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene / Science 235:177~182

Perou CM / 2000 / Molecular portraits of human breast tumours / Nature 406:747~752

Greene FL / 2002 / AJCC Cancer Staging Manual / Springer

Gajdos C / 1999 / Lymphatic invasion, tumor size, and age are independent predictors of axillary lymph node metastases in women with T1 breast cancers / Ann Surg 230:692~696

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