ĐÁNH GIÁ TÌNH TRẠNG DI CĂN HẠCH NÁCH VÀ MỘT SỐ YẾU TỐ LIÊN QUAN TRÊN BỆNH NHÂN UNG THƯ VÚ GIAI ĐOẠN I –IIIA ĐƯỢC PHẪU THUẬT TẠI BỆNH VIỆN BẠCH MAI

Abstract

Objective: To assess axillary lymph node metastasis and identify associated prognostic factors in patients with stage I-IIIA breast cancer who underwent surgery at Bach Mai Hospital. Materials and Methods: This retrospective, cross-sectional study included 37 patients with stage I-IIIA breast cancer who underwent either total mastectomy or breast-conserving surgery with axillary lymph node dissection at Bach Mai Hospital between January 2021 and January 2024. Results: Most of the study participants were aged ≥ 40 years (83.7%). Tumor size were predominantly at T1 or T2 stages (94.6%), located in the upper outer quadrant (67.6%). In most cases, fewer than 10 lymph nodes were removed post-surgery (54.0%). The most common histological type was invasive carcinoma of no special type (NST) (89.2%), with the majority graded at histological grade II (70.2%). Most tumors exhibited no vascular, lymphatic, or neural invasion (90.9%, 78.4%, and 95.5%, respectively). Estrogen receptor positivity (ER+) was present in 67.6% of cases, progesterone receptor positivity (PR+) in 64.9%, and HER2 overexpression in 43.2%, with a high Ki67 index observed in 59.5% of cases. The axillary lymph node metastasis rate was 43.0%. Clinical assessment of axillary lymph nodes demonstrated low sensitivity and specificity, with a high false-negative rate. Tumor size was identified as a significant factor affecting axillary lymph node metastasis, with a p-value of <0.05. Conclusion: The rate of axillary lymph node metastasis in stage I-IIIA breast cancer patients was 43.0%, with 24.3% of the patients having metastasis in 1-3 lymph nodes, and 18.7% with metastasis in four or more nodes. Tumor size was a significant factor associated with axillary lymph node metastasis (p = 0.045).