Prediction of nonsentinel lymph node metastasis in breast cancer patients with one or two positive sentinel lymph nodes

Asian J Surg. 2018 Jan;41(1):12-19. doi: 10.1016/j.asjsur.2016.06.001. Epub 2016 Aug 31.

Abstract

Objective: The aim of the present study was to investigate the association between non sentinel lymph node metastasis (NSLNM) and clinicopathological factors, particularly in the case of sentinel lymph node (SLN) metastasis in one or two, in clinically node negative patients with breast cancer.

Methods: Between 10/2010 and 10/2014, 350 sentinel lymph node biopsy (SLNB) were performed in patients with histologically proven primary breast cancer in our clinic. The data collection includes the following characteristics: age, pathological tumor size, histological type, histological grade, lymphovascular invasion (LVI), number of positive SLN, size of the SLN metastasis (macrometastasis, micrometastasis, isolated tumor cells), multifocality (MF), extracapsuler invasion (ECI) of the SLN, the estrogen receptor (ER) status, the progesterone receptor (PR) status and the Her 2 receptor status, Ki 67 reseptor status. Data were collected retrospectively and then analyzed.

Results: A successful SLN biopsy were performed in 345 (98.5%) cases. SLN metastases were detected in 110 (31.8%) cases. These patients then underwent axillary dissection; among these patients, 101 (91.8%) had only one to two positive SLNs. Of the 101 patients with positive SLN biopsies, 32 (31.6%) had metastases in the NSLNs. Univariate and multivariate analysis showed that lymphovascular invasion, extracapsular invasion (ECI), Her-2 receptor positive, and Ki-67 > 14% were related to NSLNM (p<.0.05).

Conclusion: The predicting factors of NSLNM were LVI, ECI, Ki-67 level, Her-2 reseptor positive and but should be further validated in our institutions, different institutions and different patient groups prospectively.

Keywords: Her-2 status; Ki-67; breast cancer; clinically node negative; extracapsuler invasion; non sentinel lymph node.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / pathology*
  • Carcinoma, Ductal, Breast / pathology*
  • Carcinoma, Lobular / pathology*
  • Female
  • Humans
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Middle Aged
  • Retrospective Studies
  • Sentinel Lymph Node
  • Sentinel Lymph Node Biopsy