The metastasis of breast cancer to the axillary lymph nodes represents a crucial aspect of disease progression and prognostic evaluation. The presence of metastases in the axillary lymph nodes is a key indicator that breast cancer is in an advanced stage, which can influence the therapeutic approach and the patient's prognosis. For this reason, we conducted a study aimed at examining the factors that contribute to the presence of metastases in lymph nodes in our female population. This research represents a prospective study conducted at the Institute of Oncology of Vojvodina in Sremska Kamenica. The study included 72 female participants diagnosed with breast cancer who underwent surgery at the Institute of Oncology of Vojvodina and had not received preoperative chemotherapy or radiation therapy. Initially, anamnestic data were collected from the participants, followed by a pathohistological analysis of the tumor tissue samples, including immunohistochemical analysis. We examined the influence of age, tumor size, activity of estrogen, progesterone, and HER2 receptors (human epidermal growth factor receptor-2)  in tumors, as well as the occurrence of menarche and breastfeeding duration, on the presence of metastases in axillary lymph nodes. The results of binary logistic regression showed that the only significant predictor for the presence of metastases in axillary lymph nodes was tumor size (p=0.01, Wald=6.57, and Exp(B)=1.11), while the other examined predictors were not statistically significant (p>0.05). In our study population, the size of the breast cancer was crucial for the presence of metastases in the axillary lymph nodes.

This research was supported by the Science Fund of the Republic of Serbia, #7750238, Exploring new avenues in breast cancer research: Redox and metabolic reprogramming of cancer and associated adipose tissue - REFRAME.

Variations in body size and shape might be linked to different biological processes that affect breast cancer risk. Еpidemiological studies have confirmed that obesity, which is characterized by increased overall adiposity and assessed using body mass index (BMI), has direct relationship with the risk of breast cancer among postmenopausal women, and opposite relationship with the risk among premenopausal women (“obesity paradox”). In addition to BMI, anthropometric descriptors of body shape, like waist and hip circumference and waist-to-hip ratio are directly associated with both pre- and postmenopausal breast cancer risk. Excess adipose tissue, adipose tissue dysfunction, and adipose tissue-to-breast cancer crosstalk have important role in the initiation and progression of breast cancer due to the altered production of proinflammatory and proangiogenic mediators, growth factors, adipokines, and sex hormones, dysregulated insulin signaling pathway, as well as mitochondrial dysfunction and oxidative stress. Fat distribution pattern exerts an effect beyond the effect of overall obesity in relation to breast cancer development because of more adverse systemic metabolic effects related to visceral adiposity. Body height and its components have direct association with postmenopausal breast cancer risk. Increased risk of breast cancer in taller persons is probably due to increased levels of insulin-like growth factor (IGF-1), which is one of the major determinants of height, plays an important role in regulating breast stem cell number, and can affect cancer growth. Adult-attained height also reflects different aspects of maturation, including genetic, nutritional, and environmental factors. Assessment of changes in body height, mass, and distribution of adipose tissue throughout life is another important aspect of understanding the complex processes of metabolic reprogramming of energy pathways in breast cancer pathophysiology. Use of anthropometric descriptors of body size and shape can provide insight into underlying biological mechanisms, which is essential for developing targeted prevention and treatment strategies.

This research was supported by the Science Fund of the Republic of Serbia, #7750238, Exploring new avenues in breast cancer research: Redox and metabolic reprogramming of cancer and associated adipose tissue - REFRAME.