IMR Press / EJGO / Volume 19 / Issue 3 / pii/1998156

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with S.O.G.

Open Access Original Research

Staging nodal growth in breast cancer on a histological basis

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1 The Gade Institute, Department of Pathology, The University of Bergen, Norway
Eur. J. Gynaecol. Oncol. 1998, 19(3), 249–252;
Published: 10 June 1998

This study describes the axillary tumour-load in 484 women with breast carcinoma with spread to one or more nodes. The aim was to relate tumour-load to nodal histology. The tumour area and that of residual lymphoid tissue was measured from standardi­sed nodal sections. The presence / absence of tumor cells in the efferent vessels (EV) defined their nodal status as EV+ or EV-. The former has a poor prognosis. While the number of EV+ cases increased with the total tumour-load, the number of EV- cases decreased. In the EV+ there was high positive correlation between tumour-load and number of deaths from breast cancer, with a corresponding negative correlation in the EV-. Twice as many patients with EV+ nodes died of breast cancer compared to the EV- group. Investigation of 164 con­secutive tumour-bearing nodes showed a similar pattern. Irrespective of EV status the area of residual lymphoid tissue remained constant. Although the lymphoid area was similar the tumour-load was twice as high in the EV+ cases. These findings stress basic biological differences in the growth of breast carcinoma in the nodes. Patients with the smallest micro­metastases that are found in the afferent lymphatics of the node and the EV+ patients in which tumour cells are present in the effe­rent nodal vessels have a poor short-term prognosis. The patients with larger micrometastases in the nodal lymphoid tissue and also EV- patients with the next highest tumour-load are both of low prognostic risk, with the exception of the few EV- with an excep­tionally high tumour-load.

Breast cancer
Efferent vascular status
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