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Prediction of lymph node metastasis by tumor-infiltrating lymphocytes in T1 breast cancer
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Prediction of lymph node metastasis by tumor-infiltrating lymphocytes in T1 breast cancer
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Journal Article
Prediction of lymph node metastasis by tumor-infiltrating lymphocytes in T1 breast cancer
2020
Overview
Background
Lymph node metastasis is more likely in early-stage breast cancer with lower tumor-infiltrating lymphocyte (TIL) density. Therefore, we investigated the correlation between TILs and lymph node metastasis in cT1 breast cancer patients undergoing surgery and the usefulness of TILs in predicting sentinel lymph node metastasis (SLNM) in cT1N0M0 breast cancer.
Methods
We investigated 332 breast cancer patients who underwent surgery as the first-line treatment after preoperative diagnosis of cT1. A positive diagnosis of SLNM as an indication for axillary clearance was defined as macrometastasis in the sentinel lymph node (SLN) (macrometastasis: tumor diameter > 2 mm). Semi-quantitative evaluation of lymphocytes infiltrating the peritumoral stroma as TILs in primary tumor biopsy specimens prior to treatment was conducted.
Results
For SLN biopsy (SLNB), a median of 2 (range, 1–8) SLNs were pathologically evaluated. Sixty cases (19.4%) of SLNM (macrometastasis: 46, micrometastasis: 16) were observed. Metastasis was significantly greater in breast cancers with tumor diameter > 10 mm than in those with diameter ≤ 10 mm (p = 0.016). Metastasis was significantly associated with lymphatic invasion (p < 0.001). These two clinicopathological factors correlated with SLNM even in patients diagnosed with cN0 (tumor size; p = 0.017, lymphatic invasion; p = 0.002). Multivariate analysis for SLNM predictors revealed lymphatic invasion (p = 0.008, odds ratio [OR] = 2.522) and TILs (p < 0.001, OR = 0.137) as independent factors.
Conclusions
Our results suggest a correlation between lymph node metastasis and tumor immune-microenvironment in cT1 breast cancer. TIL density may be a predictor of SLNM in breast cancer without lymph node metastasis on preoperative imaging.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Aged
/ Biomedical and Life Sciences
/ Biopsy
/ Breast Neoplasms - immunology
/ Breast Neoplasms - pathology
/ Female
/ Health Promotion and Disease Prevention
/ Humans
/ Lymphatic Metastasis - diagnosis
/ Lymphatic Metastasis - immunology
/ Lymphocytes, Tumor-Infiltrating - immunology
/ Oncology
/ Patients
/ Sentinel Lymph Node - diagnostic imaging
/ Sentinel Lymph Node - pathology
/ Stroma
/ Surgery
/ Tumor immune-microenvironment
