Relationship between age and axillary lymph node involvement in women with breast cancer

Hans Wildiers, Ben Van Calster, Lonneke V. Van De Poll-Franse, Wouter R. Hendrickx, Jo Røislien, Ann Smeets, Robert Paridaens, Karen Deraedt, Karin Leunen, Caroline Weltens, Sabine Van Huffel, Marie Rose Christiaens, Patrick Neven

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Purpose: To study the relation between the presence of axillary lymph node (LN) involvement and age in breast cancer. Patients and Methods: The breast cancer database of the University Hospitals Leuven contains complete data on 2,227 patients with early breast cancer consecutively treated between 2000 and 2005. A multivariate piecewise logistic regression model was used to analyze LN involvement in relation to age at diagnosis. A similar analysis was then performed on a large, independent, population-based database from the Eindhoven Cancer Registry to investigate whether the effects of the Leuven model could be replicated. Results: We observed a piecewise effect of age. That is, women up to 70 years of age were less likely to have positive LNs with increasing age (odds ratio per 10-year increase, 0.87). In contrast, older women were more likely to have positive LNs with increasing age. However, for older women, the effect of age interacted with tumor size (P = .0044), suggesting that increasing age is associated with increased risk of LN involvement, mainly in small tumors. These findings were replicated in the Eindhoven Cancer Registry database. Conclusion: Axillary LN involvement varies with age at diagnosis; its probability decreases with increasing age up to the age of approximately 70 years, but increases again thereafter. However, this increase is mainly seen in smaller tumors and suggests a different behavior of small breast cancers in older adult patients. We hypothesize that decreased immune defense mechanisms, related with aging, may play a role in earlier invasion into LNs.

Original languageEnglish
Pages (from-to)2931-2937
Number of pages7
JournalJournal of Clinical Oncology
Issue number18
Publication statusPublished - 20 Jun 2009
Externally publishedYes


ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Wildiers, H., Van Calster, B., Van De Poll-Franse, L. V., Hendrickx, W. R., Røislien, J., Smeets, A., Paridaens, R., Deraedt, K., Leunen, K., Weltens, C., Van Huffel, S., Christiaens, M. R., & Neven, P. (2009). Relationship between age and axillary lymph node involvement in women with breast cancer. Journal of Clinical Oncology, 27(18), 2931-2937.