The Distance Between Breast Cancer and the Skin is Associated With Axillary Nodal Metastasis

Background and ObjectivesMore superficially located tumors may be more likely than deeper tumors to metastasize to the axillary nodes via the lymphatics. The aim of this study was to determine whether breast cancer distance from the skin affects axillary node metastasis, ipsilateral breast cancer recurrence, or recurrence-free survival. Materials and MethodsA total of 1,005 consecutive patients with breast cancer who underwent surgery between January 2003 and December 2009 were selected. The distance of the tumor from the skin was measured from the skin to the most anterior hypoechoic leading edge of the lesion. ResultsIn total, 603 (68%) patients had no axillary nodal metastasis, and 288 (32%) had axillary nodal metastasis. A breast cancer distance from the skin <3mm induced more axillary nodal metastasis (P=0.039). However, no significant correlation was observed between breast cancer distance from the skin <3mm and ipsilateral breast cancer recurrence (P=0.788) or recurrence-free survival (P=0.353). ConclusionsBreast cancers located closer to the skin had a higher incidence of axillary nodal metastasis. Therefore, tumor distance from the skin should be considered when evaluating a patient with breast cancer and considering the risk of nodal metastasis. J. Surg. Oncol. 2015 111:824-828. (c) 2014 Wiley Periodicals, Inc.