The Significance of Extent of Extracapsular Extension in Patients with T1-2 and N1 Breast Cancer
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Original Article
P: 218-224
October 2018

The Significance of Extent of Extracapsular Extension in Patients with T1-2 and N1 Breast Cancer

Eur J Breast Health 2018;14(4):218-224
1. Department of Radiation Oncology, Necmettin Erbakan University Meram Medicine School, Konya, Turkey
2. Department of Pathology, Necmettin Erbakan University Meram Medicine School, Konya, Turkey
No information available.
No information available
Received Date: 02.03.2018
Accepted Date: 20.06.2018
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ABSTRACT

Objective:

The prognostic importance of extracapsular extension (ECE) in breast cancer is not yet clear, especially in patients with pathological T1-2 and N1 (pT1-2N1) disease. We aimed to investigate whether the extent of ECE was an independent prognostic factor for survival outcomes in patients with pT1-2N1 breast cancer.

Materials and Methods:

A total number of 131 patients with pT1-2N1 breast cancer treated between 2009 and 2015 were retrospectively evaluated. A single pathologist re-analyzed the histologic examples of all cases. The extent of ECE was graded from 0 to 4.

Results:

There was a significant correlation between the number of lymph nodes involved and ECE grade (p=0.004). According to the univariate analysis, lymphovascular invasion (LVI) and ECE grade were the significant prognostic factors for overall survival (OS); age, number of metastatic lymph nodes, menopausal status, and ECE grade were the prognostic factors for disease-free survival (DFS). With a median follow-up of 46 months, grade 3-4 ECE seems to be notably associated with a shorter OS and DFS in multivariate analysis. The mean OS was 85 months for the patients with grade 0-2 ECE vs 75 months for the patients with grade 3-4 ECE (p=0.003). The mean DFS was 83 months for the patients with grade 0-3 ECE vs 68 months for the patients with grade 4 ECE (p=<0.0001).

Conclusion:

This research has shown that the extent of ECE is an important prognostic factor for survival in pT1-2N1 breast cancer patients and grade 3-4 ECE seems to be notably associated with a shorter OS and DFS.

Keywords:
Axillary lymph node metastases, breast cancer, extracapsular extension, radiotherapy, prognosis