Comparison of Clinicopathological Features and Survival Between Distant Lymph Node Metastasis and Distant Micrometastasis in Breast Cancer

IF 2.7 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2026-08-01 Epub Date: 2026-07-08 DOI:10.1016/j.clbc.2026.07.005

Simin Luo, Hongna Lai, Jianli Zhao, Yinduo Zeng, Linxiaoxiao Ding, Wenjing Wu, Ying Wang, Song Tang, Herui Yao

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引用次数: 0

Abstract

Background

The clinical value of distant lymph node (DLN) metastasis for breast cancer prognosis still lacks consensus, and scholars dispute whether it should be categorized as M1 stage disease. Similarly, distant micrometastasis [M0(i+)] has been associated with adverse outcomes despite being staged as M0. This study compared the clinicopathological characteristics and survival outcomes of DLN metastasis and M0(i+) breast cancer to clarify the prognostic significance of DLN metastasis.

Method

We extracted data of female breast cancer cases diagnosed during 2018 to 2022 from the SEER database. Cases with isolated DLN metastasis or M0(i+) were enrolled. Baseline indicators were compared using chi-square test and t-test. After 1:1 propensity score matching, survival differences were analyzed. Kaplan–Meier curves and Cox models were used for OS analysis, while cumulative incidence functions and Fine–Gray models were applied to assess BCSM.

Result

Among 345,138 original cases, 1,315 patients were finally enrolled (DLN: n = 731; M0(i+): n = 584). DLN metastasis was linked to larger tumors, higher histologic grade, more ER/PR negativity, more HER2 positivity, increased triple-negative subtype, and higher T/N stage (all P < .001). Following matching, patients with DLN metastasis presented notably inferior OS and BCSM compared with those with M0(i+) status (all P < .001). Multivariate regression verified that DLN metastasis was an independent risk factor for poor prognosis, with HR of 3.82 (CI: 2.20-6.64) for OS and 3.76 (95% CI, 2.06-6.85) for BCSM.

Conclusion

DLN metastasis indicates more aggressive tumor characteristics and inferior prognosis relative to M0(i+). These findings provide evidence supporting the consideration of DLN metastasis as M1 stage disease.

查看原文本刊更多论文

乳腺癌远处淋巴结转移与远处微转移的临床病理特征及生存率比较。

背景：远端淋巴结（DLN）转移对乳腺癌预后的临床价值仍缺乏共识，学者们对是否应将其归类为M1期存在争议。类似地，远端微转移[M0(i+)]尽管分期为M0，但仍与不良预后相关。本研究通过比较DLN转移与M0（i+）乳腺癌的临床病理特征及生存结局，阐明DLN转移对预后的意义。方法：从SEER数据库中提取2018 - 2022年诊断的女性乳腺癌病例数据。纳入了孤立性DLN转移或M0（i+）的病例。基线指标比较采用卡方检验和t检验。1:1倾向评分匹配后，分析生存差异。OS分析采用Kaplan-Meier曲线和Cox模型，BCSM评价采用累积关联函数和Fine-Gray模型。结果：在345,138例原始病例中，最终纳入1315例患者（DLN: n = 731; M0(i+): n = 584）。DLN转移与肿瘤较大、组织学分级高、ER/PR阴性、HER2阳性、三阴性亚型增多、T/N分期高相关（均P < 0.001）。配对后，DLN转移患者的OS和BCSM明显低于M0（i+）状态患者（均P < 0.001）。多因素回归证实DLN转移是预后不良的独立危险因素，OS的HR为3.82 (CI: 2.20 ~ 6.64)， BCSM的HR为3.76 （95% CI, 2.06 ~ 6.85）。结论：与M0（i+）相比，DLN转移具有更强侵袭性的肿瘤特征，预后较差。这些发现为考虑DLN转移为M1期疾病提供了证据。

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

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.