DOI: http://dx.doi.org/10.18203/2349-2902.isj20181117

Correlation of coagulation markers with axillary lymph node metastasis in carcinoma breast

G. Rajendran, D. Aravind, Prasanna Venkatesh, Heber Anandan

Abstract


Background: Lymph node metastasis has been shown to be the most important prognostic marker for carcinoma breast. Lymph node involvement is not only a prognosis marker, but also an important guiding factor in deciding surgical plan as well as postoperative therapy. The aim of the study was to assess role of coagulation markers (D-dimer and factor VIII) value as predictive markers of lymph node metastasis in breast cancer

Methods: A prospective study was conducted in the Department of Surgery in with help of Departments of Biochemistry, Pathology and Radiology, KAPV&MGMGH, Trichy. 50 female patients who were diagnosed and treated as carcinoma breast in the department of surgery, MGMGH Trichy. The following variables were studied: 1. Age of patient 2. TNM stage of patients. 3. D-dimer levels 4. Factor VIII levels.

Results: There was statistically significant relationship between mean values of D-dimer and factor VIII levels and advancing stage of disease, number of pathological axillary lymph node involved, increase in histological grade of tumor, Lymphovascular invasion.

Conclusions: D-dimer and factor VIII may be used as yardstick for systemic adjuvant therapy in patients with node negative, <1 cm carcinoma breast. D-dimer may prove to be a safe, convenient and easily available biomarker which can be combined with conventional sentinel node biopsy in clinically node negative breast cancer to assess metastatic-disease in axilla and reduce false negative results.


Keywords


Antithrombin, Carcinoma, Thrombosis

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References


Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics. CA Cancer J Clin. 2000;50(1):7-33.

Joensuu H, Toikanen S, Klemi PJ. DNA index and S-phase fraction and their combinations as prognostic factors in operable ductal breast carcinoma. Cancer. 1990;66(2):331-40.

Gasparini G, Gullick WJ, Bevilacqua P, Sainsbury JR, Meli S, Boracchi P, et al. Human breast cancer: prognostic significance of the c-erb B-2 oncoprotein compared with epidermal growth factor receptor, DNA ploidy, and conventional pathologic features. J Clin Oncol. 1992;10(5):686-95.

Rao R, Euhus D, Mayo HG, Balch C. Axillary node interventions in breast cancer: a systemic review. JAMA. 2013;310(13):1385-94.

Devkaran B, Negi KD, Sharma S, Jaswal S, et al. Evaluation of plasma D-Dimer level as a predictve marker of advanced carcinoma breast. J Clin Case Rep. 2015;5:547.

Mielicki WP, Tenderenda M, Rutkowski P, Chojnowski K. Activation of blood coagulation and the activity of cancer procoagulant (EC 3.4.22.26) in breast cancer patients. Cancer Lett. 1999;146(1):61-6.

Dirix LY, Salgado R, Weytjens R, Colpaert C, Benoy I, Huget P. Plasma fibrin D-dimer levels correlate with tomour volume, progession rate and survival in patients with metastatic breast cancer. Br J Cancer. 2002;86(3):389-95.

Yigit E, Gönüllü G, Yücel I, Turgut M, Erdem D, Cakar B. Relation between hemostatic parameters and prognostic/predictive factors in breast cancer. Eur J Intern Med. 2008;19(8):602-7.

Blackwell K, Harron Z, Broadwater G, Berry D, Harris L, Iglehart JD, et al. Plasma D-dimer levels in operable breast cancer patients correlate with clinical stage and axillary lymph node status. J Clin Oncol. 2000;18(3):600-8.

Khan MZ, Khan MS, Raziq F, Khattak AM. Fibrinogen degradation products and D dimer in patients with breast carcinoma. Gomal J Med Sci. 2007;5(1):9-12.

Cianfrocca M. Prognostic and Predictive Factors in Early-Stage Breast Cancer. Oncologist. 2004;9(6):606-16.

Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305:569-75.

Ivens D, Hoe AL, Podd TJ, Hamilton CR, Taylor I, Royle GT. Assessment of morbidity from complete axillary dissection. Br J Cancer. 1992;66:136-8.