Molecular Classification of Breast Cancer and Surgical Management of Axiuary Lymph Node_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LISai-nan ,  GENGCui-zhi

Department of Breast, The Fourth Hospital, Hebei Medical Science University, Shijiazhuang 050011, China;

Corresponding author：

GENGCui-zhi, Email: gengcuizhi@hotmail.com

Keywords：

Breast cancer; Molecular classification; Sentinel lymph node; Non-sentinel lymph node; Axillary lymph node dissection

DOI：

10.7507/1007-9424.20140141

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To explore influence of molecular classification of breast cancer on surgical treatment of axillary lymph nodes. Method The related literatures which discussed the relation between molecular classification and axillary lymph node metastasis were reviewed and analyzed. Results The triple negative breast cancer had a lower rate of sentinel lymph node or non-sentinel lymph node metastasis. The axillary lymph node metastasis rate was higher in the luminal B or HER-2 overexpression subtypes. Especially, luminal B subtype had a higher risk of sentinel lymph node or non-sentinel lymph node metastasis as compared with the other subtypes. Elderly patients with breast conserving operation could be free for axillary lymph node dissection when only 1-2 sentinel lymph node metastases. There was still a positive possibility of non-sentinel lymph node for younger patients with a larger tumor size, even if the sentinel lymph node negative, the lymph node dissection may benefit these patients. Conclusion Breast cancer molecular classification should be considered for the surgery selection of axillary lymph node dissection.

Citation： LISai-nan, GENGCui-zhi. Molecular Classification of Breast Cancer and Surgical Management of Axiuary Lymph Node. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(5): 589-591. doi: 10.7507/1007-9424.20140141 Copy

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10.	NCCN Clinical Practice Guidelines in Oncology:Breast Cancer[EB/OL].Ver 1.2012.http://www.nccn.com/.
11.	Krag DN, Anderson SJ, Julian TB, et al.Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymphnode dissection in patients with clinically node-negative breast cancer:results from the NSABP B-32 randomised phaseⅢtrial[J].Lancet Oncol, 2007, 8(10):881-888.
12.	Lee JH, Kim SH, Suh YJ, et al.Predictors of axillary lymph node metastases (ALNM) in a Korean population with T1-2 breast carcinoma:triple negative breast cancer has a high incidence of ALNM irrespective of the tumor size[J].Cancer Res Treat, 2010, 42(1):30-36.
13.	Voduc KD, Cheang MC, Tyldesley S, et al.Breast cancer subty pes and the risk of local and regional relapse[J].J Clin Oncol, 2010, 28(10):1684-1691.
14.	Moghaddam Y, Falzon M, Fulford L, et al.Comparison of three mathematical models for predicting the risk of additional axillary nodal metastases after positive sentinel lymph node biopsy in early breast cancer[J].Br J Surg, 2010, 97(11):1646-1652.
15.	Reyal F, Rouzier R, Depont-Hazelzet B, et al.The molecular subtype classification is a determinant of sentinel node positivity in early breast carcinoma[J].PLoS One, 2011, 6(5):e20297.
16.	Reyal F, Belichard C, Rouzier R, et al.Non-sentinel lymph node metastasis prediction in breast cancer with metastatic sentinel lymph node:impact of molecular subtypes classification[J].PLoS One, 2012, 7(10):e47390.
17.	Zhou W, He Z, Xue J, et al.Molecular subtype classification is a determinant of non-sentinel lymph node metastasis in breast cancer patients with positive sentinel lymph nodes[J].PLoS One, 2012, 7(4):e35881.
18.	Madsen EV, Elias SG, van Dalen T, et al.Predictive factors of isolated tumor cells and micrometastases in axillary lymph nodes in breast cancer[J].Breast, 2013, 22(5):748-752.
19.	Mazouni C, Rimareix F, Mathieu MC, et al.Outcome in breast molecular subtypes according to nodal status and surgical procedures[J].Am J Surg, 2013, 205(6):662-667.

1. Goldhirsch A, Wood WC, Coates AS, et al.Strategies for subtypesdealing with the diversity of breast cancer:highlights of the St.Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011[J].Ann Oncol, 2011, 22(8):1736-1747.
2. Wiechmann L, Sampson M, Stempel M, et al.Presenting features of breast cancer differ by molecular subtype[J].Ann Surg Oncol, 2009, 16(10):2705-2710.
3. Gabos Z, Thoms J, Ghosh S, et al.The association between biological subtype and locoregional recurrence in newly diagnosed breast cancer[J].Breast Cancer Res Treat, 2010, 124(1):187-194.
4. Carey LA, Perou CM, Livasy CA, et al.Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study[J].JAMA, 2006, 295(21):2492-2502.
5. NCCN Clinical Practice Guidelines in Oncology:Breast Cancer[EB/OL].Ver 1.2010.http://www.nccn.com/.
6. Zakaria S, Pantvaidya G, Reynolds CA, et al.Sentinel node positive breast cancer patients who do not undergo axillary dissection:are they different?[J].Surgery, 2008, 143(5):641-647.
7. Hwang RF, Gonzalez-Angulo AM, Yi M, et al.Low locoregional failure rates in selected breast cancer patients with tumorpositive sentinel lymph nodes who do not undergo completion axillary dissection[J].Cancer, 2007, 110(4):723-730.
8. Takei H, Suemasu K, Kurosumi M, et al.Recurrence after sentinel lymph node biopsy with or without axillary lymph node dissection in patients with breast cancer[J].Breast Cancer, 2007, 14(1):16-24.
9. Giuliano AE, Hunt KK, Ballman KV, et al.Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis:a randomized clinical trial[J].JAMA, 2011, 305(6):569-575.
10. NCCN Clinical Practice Guidelines in Oncology:Breast Cancer[EB/OL].Ver 1.2012.http://www.nccn.com/.
11. Krag DN, Anderson SJ, Julian TB, et al.Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymphnode dissection in patients with clinically node-negative breast cancer:results from the NSABP B-32 randomised phaseⅢtrial[J].Lancet Oncol, 2007, 8(10):881-888.
12. Lee JH, Kim SH, Suh YJ, et al.Predictors of axillary lymph node metastases (ALNM) in a Korean population with T1-2 breast carcinoma:triple negative breast cancer has a high incidence of ALNM irrespective of the tumor size[J].Cancer Res Treat, 2010, 42(1):30-36.
13. Voduc KD, Cheang MC, Tyldesley S, et al.Breast cancer subty pes and the risk of local and regional relapse[J].J Clin Oncol, 2010, 28(10):1684-1691.
14. Moghaddam Y, Falzon M, Fulford L, et al.Comparison of three mathematical models for predicting the risk of additional axillary nodal metastases after positive sentinel lymph node biopsy in early breast cancer[J].Br J Surg, 2010, 97(11):1646-1652.
15. Reyal F, Rouzier R, Depont-Hazelzet B, et al.The molecular subtype classification is a determinant of sentinel node positivity in early breast carcinoma[J].PLoS One, 2011, 6(5):e20297.
16. Reyal F, Belichard C, Rouzier R, et al.Non-sentinel lymph node metastasis prediction in breast cancer with metastatic sentinel lymph node:impact of molecular subtypes classification[J].PLoS One, 2012, 7(10):e47390.
17. Zhou W, He Z, Xue J, et al.Molecular subtype classification is a determinant of non-sentinel lymph node metastasis in breast cancer patients with positive sentinel lymph nodes[J].PLoS One, 2012, 7(4):e35881.
18. Madsen EV, Elias SG, van Dalen T, et al.Predictive factors of isolated tumor cells and micrometastases in axillary lymph nodes in breast cancer[J].Breast, 2013, 22(5):748-752.
19. Mazouni C, Rimareix F, Mathieu MC, et al.Outcome in breast molecular subtypes according to nodal status and surgical procedures[J].Am J Surg, 2013, 205(6):662-667.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Molecular Classification of Breast Cancer and Surgical Management of Axiuary Lymph Node

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