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METHODS
Review analysis from a prospective database was conducted
of all patients diagnosed with < 1-cm invasive breast
cancers treated at New York Presbyterian-Cornell Medical Center
and Strang-Cornell Breast Center between January 1990 and January
1996. All patients included in this study underwent resection
of the primary tumor and axillary lymph node dissection (levels
I and II). Tumor size was determined using
the largest dimensions of the invasive component as measured
in the gross pathologic specimen and was categorized using the
tumor-node-metastases system of the American Joint Committee
on Cancer.8
Tumors were considered T1a when < 5 mm and T1b when
6 mm to 10 mm in diameter. Lymph nodes were analyzed with standard
sectioning and hematoxylin and eosin staining. No additional
sectioning or immunohistochemical staining procedures were performed
for nodal metastases. The total number of lymph nodes examined
per patient was not evaluated in this study; the influence of
the number of nodes examined and the frequency of metastases
was not assessed. Routine patient and tumor characteristics evaluated
included: age, race, tumor size, palpable versus nonpalpable
lesion, histologic type and grade, lymphatic or vascular channel
invasion (present or absent), estrogen and progesterone receptor
status (positive versus negative). Histologic grade was expressed
in three categories: well-differentiated (grade 1), intermediate
(grade 2), and poorly differentiated (grade 3).
Statistical analysis
Univariate analysis (chi-square test and chi-square test for
trend) was used to evaluate the relationship between clinical
and pathologic variables and ALNM status. Unadjusted odd ratios,
95% confidence intervals, and p values were calculated. Multivariate
logistic regression was performed to evaluate the independent
relationship between clinical and pathologic variables with ALNM
status adjusting for all other factors. Adjusted OR, 95% CI,
and p values are presented. Statistical significance was evaluated
at the 0.05 alpha level. The Statistical Analysis System was
used for all data analyses (SAS Institute, Inc., Cary, NC).
Introduction
| Methods | Results
| Discussion
| References
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