Correlation Between Tumor Size and Axillary Metastasis in Infiltrating Ductal Carcinoma: A Prospective Observational Study

Background: Axillary lymph node metastasis is an important prognostic factor in infiltrating ductal carcinoma of the breast. Tumor size is considered a major predictor of nodal involvement and disease progression. The objective is to evaluate the correlation between primary tumor size and axillary lymph node metastasis in patients with infiltrating ductal carcinoma of the breast. Material and Methods: This prospective observational study was conducted at the Department of General Surgery, SS Institute of Medical Sciences and Research Centre, Davangere over a period of 2 years and included 60 patients with histopathologically confirmed infiltrating ductal carcinoma who underwent definitive surgery with axillary lymph node dissection. Tumor size was categorized as T1 (<2 cm), T2 (2–5 cm), and T3 (>5 cm), and axillary lymph node status was assessed histopathologically. Results: The mean age was 51.6 ± 11.4 years, and the mean pathological tumor size was 3.9 ± 1.7 cm. Overall, axillary lymph node metastasis was present in 32 (53.3%) patients. Nodal positivity increased with tumor size, being 3 (20.0%) in T1 tumors, 17 (56.7%) in T2 tumors, and 12 (80.0%) in T3 tumors. Tumor size showed a significant association with axillary lymph node metastasis (p = 0.003). On multivariable analysis, tumor size, grade III tumor, and lymphovascular invasion were independent predictors of nodal metastasis. Conclusion: It is concluded that increasing tumor size is significantly associated with axillary lymph node metastasis in infiltrating ductal carcinoma. Early diagnosis of smaller tumors may reduce nodal spread and improve prognosis.

Keywords: breast cancer, infiltrating ductal carcinoma, tumor size, axillary metastasis, lymph node metastasis.