Prediction of lymph node metastases in breast cancer by clinicopathological and biological features of the primary tumor

Background  Although histologically confirmed nodal status continues to be the most important and reliable prognostic factor, preoperative assessment of nodal status has been required in order to avoid unnecessary surgery. Methods  The present review was carried out to elucidate the relationship between nodal status and various histologic/biologic factors of the primary tumor, and to evaluate their nodal predictabilities. Results  The incidence of nodal metastases increases with increasing tumor size. Nodal metastases, however, are quite uncommon in Tla (tumor sized 5 mm or less) cancers and in ductal carcimona in situ (DCIS). The use of various promising biological markers for predicting nodal status, however, seems to be still far from clinical use. Conclusion  The probability of nodal metastases is quite low in patients with Tl a cancer or DCIS. Therefore, routine axillary dissection for these patients has no diagnostic or therapeutic value.