Factors affecting metastases to non-sentinel lymph nodes in breast cancer
- Departments of Surgery and Pathology, St Vincent’s University Hospital and Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
- Correspondence to: Mr A D K Hill St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland; adkhillucd.ie
- Accepted 3 September 2003
Abstract
Aims: Because sentinel lymph node (SLN) biopsy for breast cancer has become well established, one of the challenges now is to determine which patients require a completion axillary dissection following a positive SLN biopsy.
Methods: A prospective database of patients who underwent SLN biopsy for invasive breast cancer from July 1999 to November 2002 (n = 180) was analysed. Fifty four patients (30%) had one or more positive SLN, and all underwent a completion axillary dissection. This subgroup was further analysed to delineate which factors predicted non-SLN metastasis.
Results: Twenty six of the 54 patients with a positive SLN had additional metastases in non-SLNs. Significant variables that predicted non-SLN metastasis included extranodal extension (odds ratio (OR), 17.399; 95% confidence interval (CI), 1.69 to 178.96) and macrometastasis within the SLN (OR, 6.985; 95% CI, 1.291 to 37.785).
Conclusions: In patients with invasive breast cancer and a positive SLN, extranodal extension or macrometastasis within the SLN were both independent predictors of non-SLN involvement.
- ALND, axillary lymph node dissection
- H&E, haematoxylin and eosin
- LVI, lymphovascular invasion
- SLN, sentinel lymph node
