Predictors of axillary lymph node metastasis in T-1 breast carcinoma

This study was designed to determine the predictors of axillary lymph node metastasis in Tla (less than or equal to 0.5 cm), T1b (>0.5 cm and less tha n or equal to 1.0 cm), and Tie (>1.0 cm and less than or equal to 2.0 cm) b reast cancers. The charts of 204 patients who underwent axillary lymph node dissections for T-1 breast carcinomas at our institution were reviewed. Of these, 23 (11%) patients had Tla cancers, 55 (27%) patients had T1b cancer s, and 126 (62%) patients were diagnosed with Tie lesions. Fifty patients ( 24.5%) had axillary node metastases. Of those with Tla lesions, one (4.3%) patient had axillary node involvement, compared with 9 (16.4%) patients wit h T1b and 40 (31.7%) patients with Tie lesions. Nodal involvement was signi ficantly increased in Tie cancer compared with either Tla (odds ratio = 8.2 4; P < 0.05) or T1b (odds ratio = 2.73; P < 0.05). Similar results were fou nd in tumors with grade 3 nuclear pleomorphism (odds ratio = 10.45 versus g rade 1 and 3.46 versus grade 2; P < 0.05). The presence of lymphovascular i nvasion was also associated with an increased likelihood of nodal involveme nt (odds ratio = 3.15; P < 0.05). Predictors of axillary lymph node metasta sis in T-1 breast carcinomas include increasing tumor size, grade 3 nuclear pleomorphism, and the presence of lymphovascular invasion. These predictor s may have a role in stratifying patients with T-1 breast carcinomas into s ubgroups that may benefit from less invasive methods of evaluating axillary lymph node status.