Background: Tumor characteristics was sought to be related to axillary lymph node metastasis (ALNM), the paramount prognostic factor in patients with invasive breast cancer. This study was aimed to identify the ALNM-associated tumor characteristics and to determine the predictive clinical pathway. Material/Methods: Data from 1325 patients diagnosed with invasive breast cancer between January 2004 and January 2010 were retrospectively reviewed. The structure equation model (SEM) was used to build the predictive clinical pathway. Results: Among the factors found in the final model, the status of human epidermal growth factor receptor 2 is the primary influence on ALNM through histology grade (b=0.18), followed by tumor size (b=0.16). Tumor size was highly relevant to lymphovascular invasion (LVI) and influenced ALNM through LVI (b=0.26), the strongest predictor of ALNM in the final model (b=0.46) and the highest risk of ALNM (odds ratio=9.282; 95% confidence interval: 7.218-11.936). Conclusions: The structure equation model presented the relation of these important predictors, and might help physicians to assess axillary nodal condition and appropriate surgical procedures.
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