Sf. Abdessalam et al., Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancer, AM J SURG, 182(4), 2001, pp. 316-320
Objective: The purpose of this study was to determine the factors that pred
ict the presence of metastasis in nonsentinel lymph nodes (SLN) when the SL
N is positive.
Methods: A prospective database was analyzed and included patients who unde
rwent SLN biopsy for invasive breast cancer from July 1997 to August 2000 (
n = 442). One hundred (22.6%) patients had one or more positive SLNs, and w
ere analyzed to determine factors that predicted additional positive axilla
ry nodes.
Results: Of the 100 patients with a positive SLN, 40 patients (40%) had add
itional metastasis in non-SLNs. The only significant variables that predict
ed non-SLN metastasis were tumor lymphovascular invasion (P = 0.004), extra
nodal extension (P < 0.001), and increasing size of the metastasis within t
he SLN (P = 0.011). In analyzing just those patients who had lymphovascular
invasion, extranodal extension, and a SLN metastasis > 2mm, 92% were found
to have additional positive nodes.
Conclusions: In patients with invasive breast cancer and a positive sentine
l lymph node, lymphovascular invasion, extranodal extension, and increasing
size of the metastasis all significantly increase the frequency of additio
nal positive nodes. (C) 2001 Excerpta Medica, Inc. All rights reserved.