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 Tla cancer or DCIS. Therefore, routine axillary dissection for these patients has no diaqnostic or therapeutic value.