title: Predictors of positive axillary lymph nodes in breast cancer patients with metastatic sentinel lymph node.
abstract: BACKGROUND
  Breast cancer with metastatic sentinel lymph nodes (SLN) may have clinico-pathologic factors associated with the presence of positive non-sentinel axillary nodes (NSLN). The aim of the present study was to determine factors that predict involvement of NSLN in breast cancer patients with positive SLN.
  
  
  METHODS
  A prospective database search identified 80 patients who underwent SLN biopsy for invasive breast cancer between January 1999 and August 2002. Clinico-pathologic data was analyzed to determine factors that predicted additional positive axillary nodes.
  
  
  RESULTS
  A total of 23 patients had positive SLN and underwent conventional axillary lymph node dissection. Statistical analysis revealed that lympho-vascular invasion (p~0.00000), SLN metastasis >2 mm (p=0.002), and the presence of extra-nodal involvement (p=0.002), were positive predictors of the metastatic involvement of NSLN.
  
  
  CONCLUSIONS
  The likelihood of positive NSLN correlates with pathologic parameters such as the presence of lympho-vascular invasion, size of the SLN metastasis, and extra-nodal involvement. These data may be helpful with the regard to the decision to undertake axillary dissection in breast cancer patients with metastatic sentinel lymph nodes.
authors.affiliation: Department of Surgery, Portuguese Institute of Cancer, Lisbon, Portugal. ijcallejo@netcabo.pt
authors.forename: Isabel Peixoto
authors.initials: IP
authors.lastname: Callejo
authors.forename: José Américo
authors.initials: JA
authors.lastname: Brito
authors.forename: José Wheinholtz
authors.initials: JW
authors.lastname: Bivar
authors.forename: Fernando Jesus
authors.initials: FJ
authors.lastname: Fernandes
authors.forename: João Leal
authors.initials: JL
authors.lastname: Faria
authors.forename: María Saudade
authors.initials: MS
authors.lastname: André
authors.forename: Carlos Santos
authors.initials: CS
authors.lastname: Costa
authors.forename: M Odette
authors.initials: MO
authors.lastname: Almeida
authors.forename: J
authors.initials: J
authors.lastname: Meneses e Sousa
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy