Impact of Micrometastatic Axillary Nodes on Survival of Breast Cancer Patients with Tumors ≤2 cm

Hyeon Woo Bae, Kwang Hyun Yoon, Joo Heung Kim, Sung Mook Lim, Jee Ye Kim, Hyung Seok Park, Seho Park, Seung Il Kim, Young Up Cho, Byeongwoo Park

Research output: Contribution to journalArticle

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Abstract

Background: This study investigated the impact of pN1mi disease on the survival of T1 breast cancer patients and examined the clinical usefulness of the online PREDICT tool and updated staging system. Methods: The node stages of 2344 patients were divided into pN0, pN1mi, and pN1a. Clinicopathological parameters and survival outcomes were retrospectively analyzed. Data for 111 micrometastatic diseases were applied to the PREDICT version 2.0 and re-classified using the 8th edition of the cancer staging manual. Results: Univariable analyses demonstrated worse disease-free and overall survival rates for patients with node-positive cancer; however, the significance was not maintained in multivariable analyses. Chemotherapy improved outcomes in patients with node-positive and non-luminal A-like subtype cancers. The PREDICT tool demonstrated good performance when estimating the 5-year overall survival for pN1mi disease (area under the receiver operating characteristic curve, 0.834). According to the updated staging system, 74% of cases were down-staged to IA, and clearly splitting survival curves were identified. Conclusion: pN1mi disease alone did not adversely affect survival outcomes. Biologic and treatment factors determined outcomes in cases of small-volume node micrometastasis. The PREDICT tool or new staging classification could help predict the survival of patients with micrometastatic sentinel nodes.

Original languageEnglish
Pages (from-to)3969-3978
Number of pages10
JournalWorld Journal of Surgery
Volume42
Issue number12
DOIs
Publication statusPublished - 2018 Dec 1

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Breast Neoplasms
Survival
Neoplasms
Neoplasm Micrometastasis
Neoplasm Staging
Biological Factors
ROC Curve
Disease-Free Survival
Survival Rate
Drug Therapy
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Bae, Hyeon Woo ; Yoon, Kwang Hyun ; Kim, Joo Heung ; Lim, Sung Mook ; Kim, Jee Ye ; Park, Hyung Seok ; Park, Seho ; Kim, Seung Il ; Cho, Young Up ; Park, Byeongwoo. / Impact of Micrometastatic Axillary Nodes on Survival of Breast Cancer Patients with Tumors ≤2 cm. In: World Journal of Surgery. 2018 ; Vol. 42, No. 12. pp. 3969-3978.
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abstract = "Background: This study investigated the impact of pN1mi disease on the survival of T1 breast cancer patients and examined the clinical usefulness of the online PREDICT tool and updated staging system. Methods: The node stages of 2344 patients were divided into pN0, pN1mi, and pN1a. Clinicopathological parameters and survival outcomes were retrospectively analyzed. Data for 111 micrometastatic diseases were applied to the PREDICT version 2.0 and re-classified using the 8th edition of the cancer staging manual. Results: Univariable analyses demonstrated worse disease-free and overall survival rates for patients with node-positive cancer; however, the significance was not maintained in multivariable analyses. Chemotherapy improved outcomes in patients with node-positive and non-luminal A-like subtype cancers. The PREDICT tool demonstrated good performance when estimating the 5-year overall survival for pN1mi disease (area under the receiver operating characteristic curve, 0.834). According to the updated staging system, 74{\%} of cases were down-staged to IA, and clearly splitting survival curves were identified. Conclusion: pN1mi disease alone did not adversely affect survival outcomes. Biologic and treatment factors determined outcomes in cases of small-volume node micrometastasis. The PREDICT tool or new staging classification could help predict the survival of patients with micrometastatic sentinel nodes.",
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Bae, HW, Yoon, KH, Kim, JH, Lim, SM, Kim, JY, Park, HS, Park, S, Kim, SI, Cho, YU & Park, B 2018, 'Impact of Micrometastatic Axillary Nodes on Survival of Breast Cancer Patients with Tumors ≤2 cm', World Journal of Surgery, vol. 42, no. 12, pp. 3969-3978. https://doi.org/10.1007/s00268-018-4725-4

Impact of Micrometastatic Axillary Nodes on Survival of Breast Cancer Patients with Tumors ≤2 cm. / Bae, Hyeon Woo; Yoon, Kwang Hyun; Kim, Joo Heung; Lim, Sung Mook; Kim, Jee Ye; Park, Hyung Seok; Park, Seho; Kim, Seung Il; Cho, Young Up; Park, Byeongwoo.

In: World Journal of Surgery, Vol. 42, No. 12, 01.12.2018, p. 3969-3978.

Research output: Contribution to journalArticle

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T1 - Impact of Micrometastatic Axillary Nodes on Survival of Breast Cancer Patients with Tumors ≤2 cm

AU - Bae, Hyeon Woo

AU - Yoon, Kwang Hyun

AU - Kim, Joo Heung

AU - Lim, Sung Mook

AU - Kim, Jee Ye

AU - Park, Hyung Seok

AU - Park, Seho

AU - Kim, Seung Il

AU - Cho, Young Up

AU - Park, Byeongwoo

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N2 - Background: This study investigated the impact of pN1mi disease on the survival of T1 breast cancer patients and examined the clinical usefulness of the online PREDICT tool and updated staging system. Methods: The node stages of 2344 patients were divided into pN0, pN1mi, and pN1a. Clinicopathological parameters and survival outcomes were retrospectively analyzed. Data for 111 micrometastatic diseases were applied to the PREDICT version 2.0 and re-classified using the 8th edition of the cancer staging manual. Results: Univariable analyses demonstrated worse disease-free and overall survival rates for patients with node-positive cancer; however, the significance was not maintained in multivariable analyses. Chemotherapy improved outcomes in patients with node-positive and non-luminal A-like subtype cancers. The PREDICT tool demonstrated good performance when estimating the 5-year overall survival for pN1mi disease (area under the receiver operating characteristic curve, 0.834). According to the updated staging system, 74% of cases were down-staged to IA, and clearly splitting survival curves were identified. Conclusion: pN1mi disease alone did not adversely affect survival outcomes. Biologic and treatment factors determined outcomes in cases of small-volume node micrometastasis. The PREDICT tool or new staging classification could help predict the survival of patients with micrometastatic sentinel nodes.

AB - Background: This study investigated the impact of pN1mi disease on the survival of T1 breast cancer patients and examined the clinical usefulness of the online PREDICT tool and updated staging system. Methods: The node stages of 2344 patients were divided into pN0, pN1mi, and pN1a. Clinicopathological parameters and survival outcomes were retrospectively analyzed. Data for 111 micrometastatic diseases were applied to the PREDICT version 2.0 and re-classified using the 8th edition of the cancer staging manual. Results: Univariable analyses demonstrated worse disease-free and overall survival rates for patients with node-positive cancer; however, the significance was not maintained in multivariable analyses. Chemotherapy improved outcomes in patients with node-positive and non-luminal A-like subtype cancers. The PREDICT tool demonstrated good performance when estimating the 5-year overall survival for pN1mi disease (area under the receiver operating characteristic curve, 0.834). According to the updated staging system, 74% of cases were down-staged to IA, and clearly splitting survival curves were identified. Conclusion: pN1mi disease alone did not adversely affect survival outcomes. Biologic and treatment factors determined outcomes in cases of small-volume node micrometastasis. The PREDICT tool or new staging classification could help predict the survival of patients with micrometastatic sentinel nodes.

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