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Prediction of Metastases to Axillary Lymph Nodes in Women with Invasive Breast Carcinoma

Purpose: To estimate the chances that a woman with an invasive breast carcinoma will show a metastasis to an axillary lymph node.

Description

The probability that axillary lymph nodes are involved in a woman with invasive breast carcinoma can be predicted based on the clinical examination of the patient and pathologic examination of the primary tumor.


Parameters:

1) size of primary tumor in centimeters

2) presence of lymphatic and/or vascular invasion

3) palpable axillary lymph nodes

4) palpable primary tumor, vs detected on mammography

 

Size of Lesion in cm

Lymphatic and/or Vascular Invasion

Axillary Node Palpable?

Primary Tumor Palpable?

Probability of Lymph Node Involvement

0.0 - 0.5

N

Y

 

0.50

0.6 – 1.0

N

Y

 

0.75

1.1 – 1.5

N

Y

 

0.93

1.6 – 2.0

N

Y

 

0.80

2.1 – 2.5

N

Y

 

0.70

2.6 – 3.0

N

Y

 

0.71

3.1 – 5.0

N

Y

 

0.77

5.1 – 10.0

N

Y

 

0.93

0.0 – 0.5

N

N

Y

0.06

0.6 – 1.0

N

N

Y

0.13

1.1 – 1.5

N

N

Y

0.19

1.6 – 2.0

N

N

Y

0.20

2.1 – 2.5

N

N

Y

0.30

2.6 – 3.0

N

N

Y

0.27

3.1 – 5.0

N

N

Y

0.34

5.1 – 10.0

N

N

Y

0.65

0.0 – 0.5

N

N

N

0.04

0.6 – 1.0

N

N

N

0.11

1.1 – 1.5

N

N

N

0.12

1.6 – 2.0

N

N

N

0.10

2.1 – 2.5

N

N

N

0.20

2.6 – 3.0

N

N

N

0.33

3.1 – 5.0

N

N

N

0.57

5.1 – 10.0

N

N

N

0.67

0.0 – 0.5

Y

Y

 

1.0

0.6 – 1.0

Y

Y

 

1.0

1.1 – 1.5

Y

Y

 

1.0

1.6 – 2.0

Y

Y

 

0.92

2.1 – 2.5

Y

Y

 

0.90

2.6 – 3.0

Y

Y

 

0.96

3.1 – 5.0

Y

Y

 

0.98

5.1 – 10.0

Y

Y

 

1.0

0.0 – 0.5

Y

N

Y

0.23

0.6 – 1.0

Y

N

Y

0.28

1.1 – 1.5

Y

N

Y

0.37

1.6 – 2.0

Y

N

Y

0.49

2.1 – 2.5

Y

N

Y

0.65

2.6 – 3.0

Y

N

Y

0.67

3.1 – 5.0

Y

N

Y

0.66

5.1 – 10.0

Y

N

Y

0.77

0.0 – 0.5

Y

N

N

0.00

0.6 – 1.0

Y

N

N

0.18

1.1 – 1.5

Y

N

N

0.30

1.6 – 2.0

Y

N

N

0.39

2.1 – 2.5

Y

N

N

0.42

2.6 – 3.0

Y

N

N

0.33

3.1 – 5.0

Y

N

N

0.50

5.1 – 10.0

Y

N

N

1.0

 

Risk Groups

 

High risk (risk >= 50%):

• clinically palpable axillary lymph nodes

• palpable primary, lymphatic or vascular invasion present, primary >= 2 cm in diameter

• nonpalpable primary, lymphatic or vascular invasion present, primary >= 3 cm in diameter

• primary size >= 5.1 cm

 

Intermediate risk (risk > 15% to 49%):

• any not in very low, low or high risk groups

 

Low risk (risk 10% - 15%):

• nonpalpable primary, lymphatic or vascular invasion absent, primary 0.6 to 2.0 cm

• palpable primary, lymphatic or vascular invasion absent, primary 0.6 – 1.0 cm

 

Very low risk (risk < 10%):

• nonpalpable primary, primary  <= 0.5 cm in diameter

• palpable primary, lymphatic or vascular invasion absent, primary <= 0.5 cm

 

Risk Group

Nodes Negative

>=1 Node Positive

>= 4 Nodes Positive

very low

95.2%

4.8%

1.4%

low

87.6%

12.4%

1.8%

intermediate

71.8%

28.2%

5.3%

high

25.8%

74.2%

29.0%

after Table 6, page 953


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Specialty

Objective

ICD-10