Distance of breast cancer from the skin and nipple impacts axillary nodal metastases

Bijan Ansari, Marilyn J. Morton, Darcy L. Adamczyk, Katie N. Jones, Julie K. Brodt, Amy C Degnim, James W Jakub, Christine M. Lohse, Judy C Boughey

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Lymphatic drainage of the breast is via subareolar and dermal lymphatics. The aim of this study was to determine whether distance of breast cancers from the skin and/or distance from the nipple impacts the likelihood of axillary nodal metastases. Methods: A retrospective review was performed of sonographically visible T1 and T2 breast cancers with breast and axillary surgery performed at Mayo Clinic, Rochester, MN. Distance of tumor from the nipple was reviewed. Ultrasounds were reviewed to measure the distance of tumor from the skin. Results: Data were collected on 233 eligible T1 or T2 breast cancers, of which 177 (76%) were node negative and 56 (24%) were node positive. On multivariable analysis, tumor stage and lymphovascular invasion, as well as decreasing distance of the tumor from the nipple and decreasing distance of the tumor from the skin, were significantly associated with axillary lymph node positivity. Each 1-cm decrease in the distance of the tumor from the nipple was associated with a 23% increased likelihood of positive lymph nodes (odds ratio 1.23; P =.003). Each 1-mm decrease in the distance of the tumor from the skin was associated with a 15% increased likelihood of positive lymph nodes (odds ratio 1.15; P =.003). Conclusion: T1 and T2 breast cancers located closer to the skin and those located closer to the nipple have a higher incidence of metastases to axillary lymph nodes. Distance from the skin and distance from the nipple should be considered when estimating a patient's likelihood of axillary nodal positivity.

Original languageEnglish (US)
Pages (from-to)3174-3180
Number of pages7
JournalAnnals of Surgical Oncology
Volume18
Issue number11
DOIs
StatePublished - Oct 2011

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Nipples
Skin Neoplasms
Breast Neoplasms
Neoplasm Metastasis
Skin
Lymph Nodes
Neoplasms
Odds Ratio
Drainage
Breast
Incidence

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Distance of breast cancer from the skin and nipple impacts axillary nodal metastases. / Ansari, Bijan; Morton, Marilyn J.; Adamczyk, Darcy L.; Jones, Katie N.; Brodt, Julie K.; Degnim, Amy C; Jakub, James W; Lohse, Christine M.; Boughey, Judy C.

In: Annals of Surgical Oncology, Vol. 18, No. 11, 10.2011, p. 3174-3180.

Research output: Contribution to journalArticle

Ansari, Bijan ; Morton, Marilyn J. ; Adamczyk, Darcy L. ; Jones, Katie N. ; Brodt, Julie K. ; Degnim, Amy C ; Jakub, James W ; Lohse, Christine M. ; Boughey, Judy C. / Distance of breast cancer from the skin and nipple impacts axillary nodal metastases. In: Annals of Surgical Oncology. 2011 ; Vol. 18, No. 11. pp. 3174-3180.
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abstract = "Background: Lymphatic drainage of the breast is via subareolar and dermal lymphatics. The aim of this study was to determine whether distance of breast cancers from the skin and/or distance from the nipple impacts the likelihood of axillary nodal metastases. Methods: A retrospective review was performed of sonographically visible T1 and T2 breast cancers with breast and axillary surgery performed at Mayo Clinic, Rochester, MN. Distance of tumor from the nipple was reviewed. Ultrasounds were reviewed to measure the distance of tumor from the skin. Results: Data were collected on 233 eligible T1 or T2 breast cancers, of which 177 (76{\%}) were node negative and 56 (24{\%}) were node positive. On multivariable analysis, tumor stage and lymphovascular invasion, as well as decreasing distance of the tumor from the nipple and decreasing distance of the tumor from the skin, were significantly associated with axillary lymph node positivity. Each 1-cm decrease in the distance of the tumor from the nipple was associated with a 23{\%} increased likelihood of positive lymph nodes (odds ratio 1.23; P =.003). Each 1-mm decrease in the distance of the tumor from the skin was associated with a 15{\%} increased likelihood of positive lymph nodes (odds ratio 1.15; P =.003). Conclusion: T1 and T2 breast cancers located closer to the skin and those located closer to the nipple have a higher incidence of metastases to axillary lymph nodes. Distance from the skin and distance from the nipple should be considered when estimating a patient's likelihood of axillary nodal positivity.",
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AU - Ansari, Bijan

AU - Morton, Marilyn J.

AU - Adamczyk, Darcy L.

AU - Jones, Katie N.

AU - Brodt, Julie K.

AU - Degnim, Amy C

AU - Jakub, James W

AU - Lohse, Christine M.

AU - Boughey, Judy C

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N2 - Background: Lymphatic drainage of the breast is via subareolar and dermal lymphatics. The aim of this study was to determine whether distance of breast cancers from the skin and/or distance from the nipple impacts the likelihood of axillary nodal metastases. Methods: A retrospective review was performed of sonographically visible T1 and T2 breast cancers with breast and axillary surgery performed at Mayo Clinic, Rochester, MN. Distance of tumor from the nipple was reviewed. Ultrasounds were reviewed to measure the distance of tumor from the skin. Results: Data were collected on 233 eligible T1 or T2 breast cancers, of which 177 (76%) were node negative and 56 (24%) were node positive. On multivariable analysis, tumor stage and lymphovascular invasion, as well as decreasing distance of the tumor from the nipple and decreasing distance of the tumor from the skin, were significantly associated with axillary lymph node positivity. Each 1-cm decrease in the distance of the tumor from the nipple was associated with a 23% increased likelihood of positive lymph nodes (odds ratio 1.23; P =.003). Each 1-mm decrease in the distance of the tumor from the skin was associated with a 15% increased likelihood of positive lymph nodes (odds ratio 1.15; P =.003). Conclusion: T1 and T2 breast cancers located closer to the skin and those located closer to the nipple have a higher incidence of metastases to axillary lymph nodes. Distance from the skin and distance from the nipple should be considered when estimating a patient's likelihood of axillary nodal positivity.

AB - Background: Lymphatic drainage of the breast is via subareolar and dermal lymphatics. The aim of this study was to determine whether distance of breast cancers from the skin and/or distance from the nipple impacts the likelihood of axillary nodal metastases. Methods: A retrospective review was performed of sonographically visible T1 and T2 breast cancers with breast and axillary surgery performed at Mayo Clinic, Rochester, MN. Distance of tumor from the nipple was reviewed. Ultrasounds were reviewed to measure the distance of tumor from the skin. Results: Data were collected on 233 eligible T1 or T2 breast cancers, of which 177 (76%) were node negative and 56 (24%) were node positive. On multivariable analysis, tumor stage and lymphovascular invasion, as well as decreasing distance of the tumor from the nipple and decreasing distance of the tumor from the skin, were significantly associated with axillary lymph node positivity. Each 1-cm decrease in the distance of the tumor from the nipple was associated with a 23% increased likelihood of positive lymph nodes (odds ratio 1.23; P =.003). Each 1-mm decrease in the distance of the tumor from the skin was associated with a 15% increased likelihood of positive lymph nodes (odds ratio 1.15; P =.003). Conclusion: T1 and T2 breast cancers located closer to the skin and those located closer to the nipple have a higher incidence of metastases to axillary lymph nodes. Distance from the skin and distance from the nipple should be considered when estimating a patient's likelihood of axillary nodal positivity.

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