title: Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancer.
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.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Arthur G. James Cancer Hospital and Solove Research Institute, Ohio State University, Columbus, OH, USA.
authors.forename: S F
authors.initials: SF
authors.lastname: Abdessalam
authors.forename: E E
authors.initials: EE
authors.lastname: Zervos
authors.forename: M
authors.initials: M
authors.lastname: Prasad
authors.forename: W B
authors.initials: WB
authors.lastname: Farrar
authors.forename: L D
authors.initials: LD
authors.lastname: Yee
authors.forename: M J
authors.initials: MJ
authors.lastname: Walker
authors.forename: W B
authors.initials: WB
authors.lastname: Carson
authors.forename: W E
authors.initials: WE
authors.lastname: Burak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy