Post-biopsy to Surgery Interval Tends to Increase Axillary Nodal Metastasis, Especially in Early Breast Cancer Patients
Objective: Delays between diagnosis and breast cancer surgery may raise concerns about tumor progression. Tumors of the same size should exhibit same proportions of N staging. We aimed to evaluate the impact of time to surgery (TTS) on the proportion of metastatic axillary lymph nodes (N-Staging),...
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Faculty of Medicine Siriraj Hospital
2024-12-01
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| Series: | Siriraj Medical Journal |
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| Online Access: | https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/270986 |
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| author | Phatcharawan Prasitviset Pongthep Pisarnturakit Adune Ratanawichitrasin |
| author_facet | Phatcharawan Prasitviset Pongthep Pisarnturakit Adune Ratanawichitrasin |
| author_sort | Phatcharawan Prasitviset |
| collection | DOAJ |
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Objective: Delays between diagnosis and breast cancer surgery may raise concerns about tumor progression. Tumors of the same size should exhibit same proportions of N staging. We aimed to evaluate the impact of time to surgery (TTS) on the proportion of metastatic axillary lymph nodes (N-Staging), controlled by tumor size.
Materials and Methods: A cross-sectional study of primary breast cancer patients treated between October 2021 - December 2022 at the Division of Head Neck and Breast Surgery, Siriraj Hospital, Thailand examined the association between lymph node staging and TTS, stratified by primary tumor size. Patients with neoadjuvant therapy, DCIS, or underwent excisional biopsy were excluded.
Results: Of 424 patients, mean age 60.95 years, had an average tumor size 17±13.38 mm, and 20.8% LNs metastasis. The mean TTS was 7 ± 3.11 weeks. The proportion of + LNs patients stratified by tumor size was 10.6% for T1, 34.56% for T2, and 43.75% for T3 lesions. There was no significant difference between TTS and the proportion of
N-staging for all T2 and T3 tumors. In contrast, a significant finding was observed among T1 tumors. Axillary nodal metastasis became more advanced as TTS increased (p-value = 0.022); and increased N2 and N3 nodal staging was noted in patients with delayed surgery. No significant additional differences were found concerning breast cancer subtype, pathological grading, or lympho-vascular/perineural invasion.
Conclusion: Increasing TTS was significantly associated with more advanced N staging. This finding highlights the need for timely intervention in early breast cancer, particularly in T1 tumors.
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| format | Article |
| id | doaj-art-3f45976b2f61431da97b1c32c229a666 |
| institution | OA Journals |
| issn | 2228-8082 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Faculty of Medicine Siriraj Hospital |
| record_format | Article |
| series | Siriraj Medical Journal |
| spelling | doaj-art-3f45976b2f61431da97b1c32c229a6662025-08-20T02:38:26ZengFaculty of Medicine Siriraj HospitalSiriraj Medical Journal2228-80822024-12-017612Post-biopsy to Surgery Interval Tends to Increase Axillary Nodal Metastasis, Especially in Early Breast Cancer PatientsPhatcharawan Prasitviset0Pongthep Pisarnturakit1Adune Ratanawichitrasin2Division of Head Neck and Breast, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Head Neck and Breast, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandFaculty of Medicine Siriraj Hospital, Mahidol University Objective: Delays between diagnosis and breast cancer surgery may raise concerns about tumor progression. Tumors of the same size should exhibit same proportions of N staging. We aimed to evaluate the impact of time to surgery (TTS) on the proportion of metastatic axillary lymph nodes (N-Staging), controlled by tumor size. Materials and Methods: A cross-sectional study of primary breast cancer patients treated between October 2021 - December 2022 at the Division of Head Neck and Breast Surgery, Siriraj Hospital, Thailand examined the association between lymph node staging and TTS, stratified by primary tumor size. Patients with neoadjuvant therapy, DCIS, or underwent excisional biopsy were excluded. Results: Of 424 patients, mean age 60.95 years, had an average tumor size 17±13.38 mm, and 20.8% LNs metastasis. The mean TTS was 7 ± 3.11 weeks. The proportion of + LNs patients stratified by tumor size was 10.6% for T1, 34.56% for T2, and 43.75% for T3 lesions. There was no significant difference between TTS and the proportion of N-staging for all T2 and T3 tumors. In contrast, a significant finding was observed among T1 tumors. Axillary nodal metastasis became more advanced as TTS increased (p-value = 0.022); and increased N2 and N3 nodal staging was noted in patients with delayed surgery. No significant additional differences were found concerning breast cancer subtype, pathological grading, or lympho-vascular/perineural invasion. Conclusion: Increasing TTS was significantly associated with more advanced N staging. This finding highlights the need for timely intervention in early breast cancer, particularly in T1 tumors. https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/270986breast cancertime to surgerylymph node staging |
| spellingShingle | Phatcharawan Prasitviset Pongthep Pisarnturakit Adune Ratanawichitrasin Post-biopsy to Surgery Interval Tends to Increase Axillary Nodal Metastasis, Especially in Early Breast Cancer Patients Siriraj Medical Journal breast cancer time to surgery lymph node staging |
| title | Post-biopsy to Surgery Interval Tends to Increase Axillary Nodal Metastasis, Especially in Early Breast Cancer Patients |
| title_full | Post-biopsy to Surgery Interval Tends to Increase Axillary Nodal Metastasis, Especially in Early Breast Cancer Patients |
| title_fullStr | Post-biopsy to Surgery Interval Tends to Increase Axillary Nodal Metastasis, Especially in Early Breast Cancer Patients |
| title_full_unstemmed | Post-biopsy to Surgery Interval Tends to Increase Axillary Nodal Metastasis, Especially in Early Breast Cancer Patients |
| title_short | Post-biopsy to Surgery Interval Tends to Increase Axillary Nodal Metastasis, Especially in Early Breast Cancer Patients |
| title_sort | post biopsy to surgery interval tends to increase axillary nodal metastasis especially in early breast cancer patients |
| topic | breast cancer time to surgery lymph node staging |
| url | https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/270986 |
| work_keys_str_mv | AT phatcharawanprasitviset postbiopsytosurgeryintervaltendstoincreaseaxillarynodalmetastasisespeciallyinearlybreastcancerpatients AT pongtheppisarnturakit postbiopsytosurgeryintervaltendstoincreaseaxillarynodalmetastasisespeciallyinearlybreastcancerpatients AT aduneratanawichitrasin postbiopsytosurgeryintervaltendstoincreaseaxillarynodalmetastasisespeciallyinearlybreastcancerpatients |