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KMID : 1134120180210040447
Journal of Breast Cancer
2018 Volume.21 No. 4 p.447 ~ p.452
Patterns of Axillary Lymph Node Metastasis in Breast Cancer: A Prospective Single-Center Study
Choi Hee-Jun

Kim Jae-Myung
Ryu Jai-Min
Kim Isaac
Nam Seok-Jin
Yu Jong-Han
Lee Se-Kyung
Lee Jeong-Eon
Kim Seok-Won
Abstract
Purpose: The recent trend in breast cancer treatment is to minimize axillary dissection. However, no pattern of axillary metastasis has been precisely established. The purpose of this study was to evaluate the metastatic lymphatic pattern using near-infrared fluorescence imaging with indocyanine green (ICG) in breast cancer with cytologically proven axillary metastasis.

Methods: This was a prospective single-center study. We evaluated 147 patients with breast cancer involving cytologically proven axillary metastasis, and compared physiological and nonphysiological lymphatic metastasis.

Results: We performed lymphatic mapping for 64 patients who exhibited level II lymphatic flow on near-infrared fluorescence imaging with ICG, and found that all had axillary metastasis: 51 patients who did not receive neoadjuvant chemotherapy (NAC) and 13 patients post-NAC. Of patients who did not receive NAC, 32 had physiological lymphatic metastasis and 19 had nonphysiological lymphatic metastasis. The risk factors for nonphysiological lymphatic metastasis were age ¡Ã55 years, high Ki-67 index (>20%), and perinodal extension in both univariate and multivariate analysis (p<0.05).

Conclusion: Patients with identified risk factors in cytologically-proven axillary metastasis who did not receive NAC may have nonphysiological lymphatic metastasis.
KEYWORD
Axilla, Breast neoplasms, Lymphatic metastasis
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