Abstract:

Objective

To study related factors of axillary lymph node metastasis in breast invasive ductal carcinoma and using ultrasound and pathology exams to predict axillary lymph node metastasis status.

Methods

One hundred and seventy-five breast invasive ductal carcinoma patients confirmed pathologically were retrospectively analyzed. All patients were examined by color Doppler ultrasound to estimate breast tumor position, tumor diameter, tumor Adler grade of blood flow, number of axillary lymph node, axillary lymph node diameter,longitudinal-transverse axis ratio of axillary lymph node, cortical thickness and blood flow grade of axillary lymph node. Pathology examinations after surgery was performed to observe tumor histological grade and expression of estrogen receptor (ER), progesterone receptor(PR), Ki67 antibody and c-erbB-2. Chi-square test and univariate and multivariate logistic regression analysis were used. ROC curve was drawn and the area under the ROC curves was calculated.

Results

Of the 175 patients, 107 were proved with axillary lymph node metastasis. Breast tumor diameter, tumor Adler grade of blood flow, number of axillary lymph node, axillary lymph node diameter, longitudinal-transverse axis ratio of axillary lymph node, cortical thickness of axillary lymph node, blood flow grade of axillary lymph node, tumor histological grade, the expression of Ki67 antibody, and c-erbB-2 positive expression were correlated with axillary lymph node metastasis (P ＜0. 050). Five factors finally entered the multivariate logistic regression model,including breast tumor diameter,cortical thickness of axillary lymph node, longitudinal-transverse axis ratio of axillary lymph node, tumor histological grades II and III and Ki67 antibody positive expression. The area under the ROC curve was 0.964.

Conclusions

Low longitudinal-transverse axis ratio of axillary lymph node, the cortical thickness of axillary lymph node ≥3 mm, breast tumor diameter≥2 cm, tumor histological grades Ⅱ and Ⅲ and positive expression of Ki67 antibody predict a high rate of axillary lymph node metastasis in breast invasive ductal carcinoma.

Key words: ultrasonography, doppler, pathology, breast invasive ductal carcinoma, axillary lymph node metastasis