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
Purpose: To estimate the chances that a woman with an invasive breast carcinoma will show a metastasis to an axillary lymph node.
Specialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology
Objective: risk factors, severity, prognosis, stage
ICD-10: C50,