Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancer

Shahab F. Abdessalam, Emmanuel E. Zervos, Manju Prasad, William B. Farrar, Lisa D. Yee, Michael J. Walker, William B. Carson, William E. Burak

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

Objective: The purpose of this study was to determine the factors that predict the presence of metastasis in nonsentinel lymph nodes (SLN) when the SLN is positive. Methods: A prospective database was analyzed and included patients who underwent 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 were analyzed to determine factors that predicted additional positive axillary nodes. Results: Of the 100 patients with a positive SLN, 40 patients (40%) had additional metastasis in non-SLNs. The only significant variables that predicted non-SLN metastasis were tumor lymphovascular invasion (P = 0.004), extranodal extension (P <0.001), and increasing size of the metastasis within the 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 sentinel lymph node, lymphovascular invasion, extranodal extension, and increasing size of the metastasis all significantly increase the frequency of additional positive nodes.

Original languageEnglish (US)
Pages (from-to)316-320
Number of pages5
JournalAmerican journal of surgery
Volume182
Issue number4
DOIs
StatePublished - Dec 3 2001

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Sentinel Lymph Node Biopsy
Lymph Nodes
Breast Neoplasms
Neoplasm Metastasis
Databases
Biopsy
Neoplasms

Keywords

  • Breast cancer
  • Predicting positive nodes
  • Sentinel lymph node

ASJC Scopus subject areas

  • Surgery

Cite this

Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancer. / Abdessalam, Shahab F.; Zervos, Emmanuel E.; Prasad, Manju; Farrar, William B.; Yee, Lisa D.; Walker, Michael J.; Carson, William B.; Burak, William E.

In: American journal of surgery, Vol. 182, No. 4, 03.12.2001, p. 316-320.

Research output: Contribution to journalArticle

Abdessalam, SF, Zervos, EE, Prasad, M, Farrar, WB, Yee, LD, Walker, MJ, Carson, WB & Burak, WE 2001, 'Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancer', American journal of surgery, vol. 182, no. 4, pp. 316-320. https://doi.org/10.1016/S0002-9610(01)00719-X
Abdessalam, Shahab F. ; Zervos, Emmanuel E. ; Prasad, Manju ; Farrar, William B. ; Yee, Lisa D. ; Walker, Michael J. ; Carson, William B. ; Burak, William E. / Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancer. In: American journal of surgery. 2001 ; Vol. 182, No. 4. pp. 316-320.
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AB - Objective: The purpose of this study was to determine the factors that predict the presence of metastasis in nonsentinel lymph nodes (SLN) when the SLN is positive. Methods: A prospective database was analyzed and included patients who underwent 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 were analyzed to determine factors that predicted additional positive axillary nodes. Results: Of the 100 patients with a positive SLN, 40 patients (40%) had additional metastasis in non-SLNs. The only significant variables that predicted non-SLN metastasis were tumor lymphovascular invasion (P = 0.004), extranodal extension (P <0.001), and increasing size of the metastasis within the 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 sentinel lymph node, lymphovascular invasion, extranodal extension, and increasing size of the metastasis all significantly increase the frequency of additional positive nodes.

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