Clinical importance of preoperative detection of the apical lymph node metastasis in patients with breast carcinoma

Guven HE, Bulak H, Turanli S, Oral S
Correspondence: Dr H Erhan Güven, heguven@gmail.com

ABSTRACT
Introduction According to the revised staging system for breast cancer, the infraclavicular node status has become more important because the involvement of the apical nodes now changes the stage of the disease for all tumour sizes. In this study, we analysed the stage migration among our patients treated with mastectomy for breast cancer.
Methods 44 patients who were treated with modified radical mastectomy for breast cancer in our department during 2003 were reviewed for their clinicopathological features, including the status of the axillary lymph nodes.
Results 11 patients (25 percent) were reclassified as stage IIIC according to the new Tumour, Node and Metastasis (TNM) classification system of American Joint Committee on Cancer that was revised in 2002. The mean age was 40.2 years and the mean tumour size was 5 cm.
Conclusion Patients with breast cancer should be properly staged preoperatively for choosing appropriate individual treatment, and more accurate evaluation of the infraclavicular region for metastatic lymph nodes should be done.

Keywords: apical lymph nodes, axillary lymph nodes, breast neoplasm, infraclavicular lumph nodes, lymphatic metastasis, modified radical mastectomy
Singapore Med J 2007; 48(1): 31–33