Izvorni znanstveni članak
Relation between metastatic involvement of interpectoral (Rotter's) lymph nodes and location, size and grade of breast cancer
Danko Velimir Vrdoljak
; Department of Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia
Vesna Ramljak
; Department of Clinical Cytology, University Hospital for Tumors, Zagreb, Croatia
Dubravka Mužina
; Department of Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia
Mladen Stanec
; Department of Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia
Miroslav Lesar
; Department of Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia
Marica Vrdoljak
; Department of Clinical Radiology, University Hospital for Tumors, Zagreb, Croatia
Andrej Roth
; Department of Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia
Gordana Brozović
; Department of Anesthesiology, University Hospital for Tumors, Zagreb, Croatia
Sažetak
The study was aimed at analyzing metastatic involvement in interpectoral (Rotter's) lymph nodes related to site, size and grade in primary breast cancer.
The study includes 210 female patients undergoing surgery for breast cancer at the University Hospital for Tumors, Zagreb, Croatia. In addition to the standard surgical procedure, interpectoral (Rotter's) lymph nodes were removed in all of the patients.
Rotter's lymph nodes were identified in 66.2% of the patients, with metastatic involvement revealed in 18.5% of the Rotter's nodes. Metastatic involvement of Rotter's nodes in patients with negative and positive axillary lymph nodes was 2.8% and 34.6%, respectively. Considering location of the tumor in patients with metastatic involvement of Rotter's nodes, it was shown that tumors located in the upper breast quadrants were more prone to metastasis to Rotter's nodes, demonstrating a significant positive correlation between tumor location within the breast and positive Rotter's lymph nodes (r=0.93, p=0.02). As regards tumor size, Rotter's nodes were identified in 15%, 20% and 60% of stage T1 (<2 cm), T2 (2-5 cm) and T3 tumors (>5 cm), respectively with a significant positive correlation (r=0.759, p=0.09). Also considering tumor grade it was shown that metastatic involvement of Rotter's lymph nodes was 3.8%, 17.6% and 31.6% of grade I,II and III, respectivly with a significant positive correlation (r=0.993, p=0.08).
The results show that one-fifth of breast cancer patients, or even one-third of them with positive axillary lymph nodes, are discharged with positive interpectoral lymph nodes that remain undiagnozed and non-extirpated. As the nodes can be surgically removed without additional mutilation, the exploration of Rotter's lymph nodes should be introduced into routine clinical practice. In upper breast quadrants, tumors were more prone to metastase in to Rotter's nodes, as well as higher tumor size and grade.
Ključne riječi
breast cancer; interpectoral (Rotter's) lymph nodes
Hrčak ID:
281790
URI
Datum izdavanja:
3.12.2003.
Posjeta: 805 *