The Relationship Between Serum Lipid Level And Axillary Lymph Node Metastasis In PT1-2Breast Cancer

Background and purpose:Breast cancer is the most common cancer among women. Prediction of axillary lymph node metastasis could be valuable to individualized treatment and evaluation of prognosis. The purpose of this study is to find the relationship between serum lipid level and axillary lymph node metastasis of operable breast cancer.Materials and methods:We collected the clinicopathological data of194women who diagnosed with invasive breast cancer and underwent radical surgery at the Department of Surgical Oncology, Second Affiliated Hospital of Zhejiang University School of Medicine, from December2010to March2012. The preoperative serum lipid level was compared between100cancer patients and one-to-one age-match benign breast diseases (including fibroadenoma, hyperplasia, intraductal papilloma and ductal ectasia) as control during the period using the T test. The correlationship between the clinicopathological characteristics including serum lipid level and axillary lymph node metastasis was then analyzed for all194cases of invasive breast cancer by Fisher’s exact test. In addition, the independent risk factors for axillary lymph node metastasis were evaluated using logistic regression model.Result:Our results showed that serum low-density-lipoprotein cholesterol (LDL-C) was significantly higher in patients with invasive breast cancer than those with benign breast diseases (P<0.05). For invasive breast cancer, nerve/vascular invasion was statitically correlated with axillary lymph node metastasis (P<0.05), while tumor size and serum LDL-C concentration were near-significantly associated with axillary lymph node metastasis (0.05≤P<0.1). Further analysis revealed that the nerve/vascular invasion, rather than tumor size and serum LDL-C, was significantly related with pN-stage (P<0.05). Logistic regression analysis proved that presence of nerve/vascular invasion and higher preoperative serum LDL-C (>120mg/dl) were independent and significant predictors of axillary lymph node metastasis(P<0.05).Conclusion:There is a difference in preoperative serum LDL-C between invasive breast cancer and benign breast diseases. For invasive breast cancer, the elevation of serum LDL-C may increase the risk of axillary lymph node metastasis in pT1-2breast cancer.