Clinical records of patients undergoing surgery for breast cancer were reviewed in order to evaluate the prognostic role of lymph-node level involvement.
From 1982 to 1991,1143 patients had radical mastectomy or conservative surgery with total axillary dissection :
461 patients of mean age 57.1 years (range : 25-89 years) were lymph-node positive (pN1) ;
369 patients (80%) had radical mastectomy ;
and 92 patients (20%) had conservative treatment plus post-operative radiotherapy, with the same mean number (n=16) of lymph nodes collected in the surgical specimen.
Data were analysed for the number of positive lymph nodes and level of involvement.
Level I, Levels I+II and Levels I+II+III were involved in 44.9. 18 and 21.4% of patients, respectively ; skip metastases'occurred in 72 of 461 pN1 patients (15.5%). A univariate analysis showed that prognosis was directly related to the number of levels involved (P<0.001), and skip metastases had the same prognostic role as Level I involvement.
The numbers of involved lymph-node levels and metastatic lymph nodes were well correlated ; multivariate analysis showed that involvement of Levels I and III was independently correlated with prognosis.
After adjustment for age and number of positive lymph nodes, the number of involved lymph-node levels was an independent prognostic factor, with highest predictability when all three lymph-node levels were positive (P=0.009). (...)
Mots-clés Pascal : Tumeur maligne, Glande mammaire, Ganglion lymphatique, Adénopathie, Métastase, Axillaire, Résection chirurgicale, Traitement, Histologie, Pronostic, Prédicteur, Homme, Femelle, Italie, Europe, Glande mammaire pathologie, Chirurgie
Mots-clés Pascal anglais : Malignant tumor, Mammary gland, Lymph node, Adenopathy, Metastasis, Axillary, Surgical resection, Treatment, Histology, Prognosis, Predictor, Human, Female, Italy, Europe, Mammary gland diseases, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0245001
Code Inist : 002B20E02. Création : 11/09/1998.