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Small Invasive Breast Carcinomas in Taiwanese Women

From the Division of General Surgery, Department of Surgery, Chang Gung University College of Medicine; and Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Correspondence: Address correspondence and reprint requests to: Tzu-Chieh Chao, MD, PhD, Department of Surgery, Chang Gung Memorial Hospital at Keelung, 222 Maichin Road, Keelung, Taiwan; Fax: 886-22433-2655; E-mail: tcchao{at}adm.cgmh.org.tw

Background: Female Taiwanese breast cancer patients are younger than their Western counterparts. This study examined the predictors of axillary lymph node metastases in Taiwanese women with T1 breast cancer.

Methods: Data from 394 Taiwanese women with T1 invasive breast carcinoma were retrospectively reviewed.

Results: The data contained 6 T1a, 51 T1b, and 337 T1c breast tumors. The patients’ ages ranged from 23 to 82 years (mean ± SD, 48.2 ± 11.4 years; median, 46.4 years). Axillary nodal metastases were present in 38.3% of the patients (16.7% in T1a, 35.3% in T1b, and 39.2% in T1c tumors). The patients with nodal metastases had significantly greater body weights and S-phase fractions than those without nodal metastases. Univariate analysis revealed that unfavorable pathology, lymphovascular invasion, S-phase fraction >7%, and nondiploid DNA ploidy were significantly associated with lymph node metastases. Lymphovascular invasion was the only significant variable as the independent predictor in the multiple logistic regression analysis. In the Cox proportional hazards regression analysis, axillary nodal status and lymphovascular invasion were significantly associated with survival.

Conclusions: Taiwanese women with small breast cancer displayed a relatively higher incidence of axillary lymph node metastases than Western women. Axillary lymph node dissection or sentinel lymph node biopsy should be conducted on Taiwanese patients with small invasive breast carcinomas, particularly when risk factors exist.

Key Words: Breast cancer • DNA ploidy • Lymphovascular invasion • Lymph nodes • S-phase fraction • Survival