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Predictive factors for additional non-sentinel lymph node involvement in breast cancer patients with one positive sentinel node

Abstract

Aim

The aim of this study was to identify a subgroup of breast cancer patients in whom it is possible to avoid axillary lymph node dissection (ALND) when the sentinel lymph node (SLN) is positive.

Methods

A series of 292 patients treated with breast-conserving surgery or mastectomy underwent ALND after positive SLN detection. To correlate SLN metastasis with the chances of finding additional metastasis in non-SLNs we evaluated the main clinicopathological characteristics. No patients received adjuvant radiotherapy to the axillary region.

Results

Fifty-six patients (35.4%) with positive SLNs for macrometastases (n = 158) had additional metastases upon completion ALND compared with 7 patients (5.2%) with micrometastases in the SLN (n = 132). Cases with a higher number of positive axillary lymph nodes tended to have higher pT stage (p = 0.004). In multivariate analysis, pT was confirmed as an independent predictor of non-SLN metastases (OR = 2.40; 95% CI = 1.16-4.99). No patients with micrometastases in SLN and cancer <10 mm had additional positive non-SLNs.

Conclusions

Our results, in agreement with the major published studies, suggest that ALND can be avoided in selected patients without the need for additional treatment to the axillary region.

Tumori 2015; 101(1): 78 - 83

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000220

Authors

Icro Meattini, Calogero Saieva, Silvia Bertocci, Giulio Francolini, Giacomo Zei, Carla De Luca Cardillo, Vieri Scotti, Daniela Greto, Pierluigi Bonomo, Lorenzo Orzalesi, Simonetta Bianchi, Lorenzo Livi

Article History

Disclosures

Financial support: None declared.
Conflict of interest: None declared.

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Authors

Affiliations

  • Department of Radiation-Oncology, University of Florence, Florence - Italy
  • Molecular and Nutritional Epidemiology Unit, ISPO (Cancer Research and Prevention Institute), Florence - Italy
  • Department of Surgery, University of Florence, Florence - Italy
  • Division of Pathological Anatomy, Department of Medical and Surgical Critical Care, University of Florence, Florence - Italy

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