Factors affecting metastases to non-sentinel lymph nodes in breast cancer.
OBJECTIVE
Because sentinel lymph node (SLN) biopsy for breast cancer has become well established, one of the challenges now is to determine which patients require a completion axillary dissection following a positive SLN biopsy.


METHODS
A prospective database of patients who underwent SLN biopsy for invasive breast cancer from July 1999 to November 2002 (n = 180) was analysed. Fifty four patients (30%) had one or more positive SLN, and all underwent a completion axillary dissection. This subgroup was further analysed to delineate which factors predicted non-SLN metastasis.


RESULTS
Twenty six of the 54 patients with a positive SLN had additional metastases in non-SLNs. Significant variables that predicted non-SLN metastasis included extranodal extension (odds ratio (OR), 17.399; 95% confidence interval (CI), 1.69 to 178.96) and macrometastasis within the SLN (OR, 6.985; 95% CI, 1.291 to 37.785).


CONCLUSIONS
In patients with invasive breast cancer and a positive SLN, extranodal extension or macrometastasis within the SLN were both independent predictors of non-SLN involvement.
Fleming
F J
FJ
Department of Surgery, St Vincent's University Hospital and Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland.
Kavanagh
D
D
Crotty
T B
TB
Quinn
C M
CM
McDermott
E W
EW
O'Higgins
N
N
Hill
A D K
AD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D018579:Patient Selection; D011446:Prospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy