Is Axillary Lymph Node Clearance Indicated in Every Case of Breast Cancer?

Abstract Background: Breast cancer is the most commonly diag-nosed cancer and the leading cause of cancer deaths in women worldwide, accounting for 25% of total cancer cases and 15% of all cancer related mortalities. Aim of Study: The aim of the work to find out predictors of axillary lymph nodes metastasis in breast cancer and to evaluate its significance in selecting the group of patients in whom axillary lymph nodes dissection could be avoided. Patients and Methods: The study was including 40 patients presented with operable breast cancer at Aswan University Hospital. All patients were undergoing modified radical mastectomy or conservative breast surgery and axillary evac-uation. All life stages were considered, all races were consid-ered. All resected tissues sent to histopathological examination. Results: In our study age is a protective factor for axillary lymph node metastasis, axillary lymph node metastasis de-crease in old age, and increase with positivity of family history, mean of percentage of positive axillary lymph nodes is higher in obese patients than in normal body weight patients, tumors in upper outer quadrant have higher level of axillary lymph node metastasis followed by tumors at lower outer quadrant, tumors larger than 2cm have higher incidence of axillary lymph node metastasis than tumors less than 2cm in size, high grade tumours have higher incidence of axillary lymph node metastasis than low grade tumors, Her 2neu expression is an important predicator for positivity of axillary lymph nodes, mean of positive axillary lymph nodes increase in mixed lobular and ductal carcinoma more than in ductal carcinoma and this result is statistically insignificant in our study. Conclusion: In conclusion this study reported factors that are highly predicator of axillary lymph node metastasis in breast cancer as, young age of patient, tumors larger than 2cm, with positive Her 2neu and positive family history, high grade tumors, tumors at upper outer quadrant, obese patient and mixed ductal and lobular carcinoma. In absence of these factors axillary node metastasis is unexpected and there axillary node dissection is not necessary and we can avoid axillary evacuation and avoid its complication.