Impact of Axillary Burden on Survival: A Comparative Study of Invasive Lobular Carcinoma and Invasive Ductal Carcinoma in Early-Stage Breast Cancer.

IF 4.5 2区 医学 Q1 ONCOLOGY
Cancers Pub Date : 2025-03-17 DOI:10.3390/cancers17061002
Kwang Hyun Yoon, Jee Hyun Ahn, Jee Ye Kim, Hyung Seok Park, Seung Il Kim, Seho Park
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Abstract

Purpose: Invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) are the most common breast cancer types. While they differ biologically and pathologically, their association with axillary lymph node (ALN) metastasis and survival remains unclear. This study compares the clinical features of ILC and IDC to evaluate ALN surgery considerations for ILC patients.

Materials and methods: We retrospectively analyzed 3543 patients who underwent upfront surgery for early breast cancer at Yonsei University Severance Hospital between January 2015 and December 2019. Multivariate logistic regression assessed factors linked to ALN metastasis, while Cox regression identified predictors of recurrence and survival.

Results: Among the patients, 92.1% had IDC and 7.9% had ILC. T2-stage tumors were more prevalent in ILC (31.4% vs. 18.1%, p < 0.001). The rates of ALN metastasis were similar between the groups (IDC: 21.1%, ILC: 24.6%, p = 0.655); however, the presence of more than two metastatic ALNs was more frequent in ILC (9.6% vs. 5.0%, p = 0.004). Factors associated with having >2 metastatic ALNs included histology, suspicious axillary ultrasound, T stage, and lymphovascular invasion. The median follow-up period was 65 months, with no significant differences observed in 8-year recurrence-free survival (ILC: 95.2%, IDC: 94.1%, p = 0.134) or 5-year overall survival (ILC: 97.1%, IDC: 97.4%, p = 0.289).

Conclusions: ILC features larger tumors and a higher nodal burden but has similar survival rates to IDC with proper treatment. Caution is essential in axillary surgery to avoid underestimating the nodal burden.

目的:浸润性导管癌(IDC)和浸润性小叶癌(ILC)是最常见的乳腺癌类型。虽然它们在生物学和病理学上存在差异,但它们与腋窝淋巴结(ALN)转移和生存的关系仍不清楚。本研究比较了ILC和IDC的临床特征,以评估ILC患者ALN手术的注意事项:我们回顾性分析了2015年1月至2019年12月期间在延世大学Severance医院接受早期乳腺癌前期手术的3543例患者。多变量逻辑回归评估了与 ALN 转移相关的因素,而 Cox 回归则确定了复发和生存的预测因素:患者中,92.1%患有IDC,7.9%患有ILC。T2期肿瘤在ILC中更为常见(31.4%对18.1%,P<0.001)。两组间的ALN转移率相似(IDC:21.1%,ILC:24.6%,P = 0.655);但ILC中出现两个以上转移性ALN的比例更高(9.6% vs. 5.0%,P = 0.004)。组织学、可疑腋窝超声、T期和淋巴管侵犯是导致转移性ALN超过2个的相关因素。中位随访期为65个月,8年无复发生存率(ILC:95.2%,IDC:94.1%,p = 0.134)和5年总生存率(ILC:97.1%,IDC:97.4%,p = 0.289)无明显差异:结论:ILC的特点是肿瘤较大、结节负担较重,但经过适当治疗后,其生存率与IDC相似。腋窝手术必须谨慎,避免低估结节负荷。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cancers
Cancers Medicine-Oncology
CiteScore
8.00
自引率
9.60%
发文量
5371
审稿时长
18.07 days
期刊介绍: Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.
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