Factors Influencing Axillary Lymph Node Metastasis in Pure Mucinous Breast Carcinoma

By: Julia Cipriano, MS
Posted: Wednesday, September 11, 2024

Cai Chang, PhD, of Fudan University, Shanghai, and colleagues conducted a single-center retrospective analysis to identify the sonographic and clinicopathologic characteristics associated with axillary lymph node metastasis in patients who were diagnosed with pure mucinous breast carcinoma after undergoing primary surgery. Their findings, published in the journal BMC Medical Imaging, underscored the significance of tumor location, with those in the outer portion of the breast demonstrating an increased likelihood of lymphatic metastasis.

“With bigger [tumor] size and/or higher expression of Ki67, lymphatic metastasis seems more likely to present,” the investigators commented. “Unlike invasive ductal carcinoma, there is no association between conventional ultrasound image parameters and axillary lymph node metastasis in pure mucinous breast carcinoma.”

The investigators focused on 176 patients who did (n = 15) and did not (n = 161) have axillary lymph node metastases. Those with tumors in the upper and/or lower outer quadrants of the breast were significantly more likely to experience lymphatic metastasis (86.7% vs 60.3%; P = .043). Neither age (P = .437) nor tumor size (P = .418) was found to be significantly associated with axillary lymph node metastasis; however, patients with vs without such disease progression had a numerically larger mean tumor diameter (32.3 vs 25.2 mm).

A total of 100% and 91% of the tumors demonstrated progesterone and estrogen receptor positivity, respectively. Two patients without axillary lymph node metastases had HER2-positive disease. High expression of Ki67 was documented 20.5% of tumors; it was numerically higher in patients with vs without axillary lymph node metastases (33.3% vs 19.3%; P = .338).

“[Studies with larger cohorts or] new ultrasonic technology, such as radiomics and ultrasonic radiofrequency signal analysis, should be performed to explore more,” the investigators concluded.

Disclosure: The study authors reported no conflicts of interest.

BMC Medical Imaging