Axillary nodal metastasis and resection margins as predictors of Loco Regional Recurrence in Breast Cancer Patients |
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Authors: | OO Ayandipo OJ Adepoju GO Ogun OO Afuwape OY Soneye IB Ulasi |
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Affiliation: | 1. Department of Surgery, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria;2. Department of Surgery, University College Hospital, Ibadan;3. Department of Pathology, College of Medicine, University of Ibadan/ University College Hospital, Ibadan, Nigeria |
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Abstract: | BackgroundSurgical resection margins (RM), axillary nodal involvement and lymph node ratio (LNR) determine loco-regional control (LRC) in breast cancer management. Late presentation precludes breast conservation therefore surgical option is usually mastectomy and adjuvant chemoradiation minimize loco-regional recurrence (LRR).ObjectiveWe investigated the prognostic role of lymph nodes positive for malignancy (pN), LNR and RM on LRR of breast cancer in a tertiary hospital in Ibadan, Nigeria.MethodsLongitudinal cohort study of 225 females with breast carcinoma managed and followed up for 5-years with end point of LRR or not. Chi-square test and logistic regression analysis were used to evaluate the interaction of resection margin and proportion of metastatic lymph nodes with LRR. The receiver-operator curve was plotted to determine the proportion of metastatic lymph nodes which predicted LRR.ResultsNinety-nine percent had modified radical mastectomy and 163 (72.4%) had negative resection margins. A mean of 11 axillary lymph nodes were harvested at surgery. The age, positive resection margin and number of harvested nodes with malignant cells are associated with LRR. The overall 5-year LRR rate was 16%.ConclusionLRR is dependent on lymph node involvement as well as and tumor aggressiveness. |
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Keywords: | Recurrence breast cancer Ibadan Axillary nodes resection margins |
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