title: Predictors of nonsentinel lymph node metastasis in breast cancer patients.
abstract: BACKGROUND
  In order to define a future subset of breast cancer patients in whom the axilla may be staged by sentinel lymph node biopsy alone, the conditions under which nonsentinel axillary lymph node metastases occur must be delineated.
  
  
  METHODS
  A prospective database including 212 breast cancer patients who underwent sentinel lymph node biopsy followed by completion axillary dissection at our institution was reviewed. A multivariate, logistic, stepwise regression was performed to evaluate the relationship between nonsentinel lymph node metastasis and patient age, primary tumor size, presence of lymphatic invasion, use of radioisotope to identify the sentinel node and degree of metastasis in the sentinel node.
  
  
  RESULTS
  Tumor size greater than 2 cm, lymphatic invasion of the primary tumor, macrometastasis in the sentinel node, and use of radioisotope all positively correlated independently with metastasis in the nonsentinel lymph node (P = 0.0001, P = 0.0483, P = 0.0008, P = 0.0271, respectively).
  
  
  CONCLUSIONS
  Predictors of nonsentinel axillary node metastasis exist and are important in defining those patients in whom a sentinel lymph node biopsy alone may not be adequate.
authors.affiliation: Department of Surgery, Mount Sinai Medical Center, One Gustave Levy Place, New York, NY 10029, USA.
authors.forename: Ulka
authors.initials: U
authors.lastname: Sachdev
authors.forename: Kara
authors.initials: K
authors.lastname: Murphy
authors.forename: Alain
authors.initials: A
authors.lastname: Derzie
authors.forename: Shabnam
authors.initials: S
authors.lastname: Jaffer
authors.forename: Ira J
authors.initials: IJ
authors.lastname: Bleiweiss
authors.forename: Steven
authors.initials: S
authors.lastname: Brower
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods