MARKER PANEL PREDICTIVE OF LYMPH-NODE METASTASIS IN YOUNG-PATIENTS WITH BREAST-CARCINOMA

Breast cancer is being diagnosed more frequently in young women. It is important to identify tumors with greater metastatic potential since this information will provide a basis for noninvasive staging of the a xilla. The studied population consisted of 66 patients with infiltrati ng breast carcinoma (56 ductal, 10 lobular) aged 20-34 (mean 29) years . Lymph node status was correlated with the following parameters: size , grade, p53 expression, MIB-1, CD44, c-Erb-2, estrogen, progesterone receptors, and a family history of breast cancer. Immunohistochemical studies utilizing avidin-biotin-peroxidase complex method were perform ed on formalin-fixed, paraffin embedded tissue. Thirty-nine patients ( 59%) had positive lymph nodes and 27 (41%) had negative lymph nodes. L n multivariate logistic regression analysis, two models with size (p = .0002) and p53 (p = .0379) or size (p = .0002) and MLB-1 (p = .0462) were predictive of nodal involvement. For T1 lesions, p53 positivity i ncreased the probability of nodal involvement from 18% to 46% and, for T2 lesions, from 65% to 89%. Ln the second model, for T1 lesions MIB- 1 positivity increased the probability of nodal involvement from 10% t o 36% and, for T2 lesions, from 48% to 82%. Size, p53, and MIB-1 were found to be valid independent predictors of lymph node metastasis in T 1 and T2 breast carcinomas in young women. The combination of size wit h p53 or MIB-1 increases dramatically the predictive impact of these p arameters on nodal status. These data may prove useful in selecting pa tients with increased risk of dissemination and provide a basis for st aging the axilla noninvasively.