title: Solitary positive sentinel lymph node accompanied by negative sentinel lymph node(s) is predictive of a negative completion axillary lymph node dissection.
abstract: BACKGROUND
  Many patients with a positive sentinel lymph node (SLN) have a negative axillary lymph node dissection (ALND). We hypothesized that a solitary positive SLN associated with at least 1 negative SLN is predictive of a negative completion ALND. Omission of ALND may be possible in these patients.
  
  
  METHODS
  A retrospective review of 392 consecutive patients who underwent SLNB was performed. The 78 (20%) SLN-positive patients were divided into 4 groups: group 1: solitary positive SLN associated with at least 1 negative SLN; group 2: more than 1 positive SLN with at least 1 negative SLN; group 3: solitary positive SLN with no additional SLNs; and group 4: more than 1 positive SLN and all SLNs positive.
  
  
  RESULTS
  Excluding extracapsular extension, only 3% of group 1 patients had a positive ALND. Positive ALND was found in 15% of group 2, 29% of group 3, and 77% of group 4.
  
  
  CONCLUSIONS
  A solitary positive SLN accompanied by additional negative SLN(s) is predictive of a negative completion ALND.
authors.affiliation: Department of Surgery, University of Kansas Medical Center, 4960 Murphy Administration Building, Mail Stop 2005, 3901 Rainbow Blvd, Kansas City, KS 66160, USA. walkhatib@kumc.edu <walkhatib@kumc.edu>
authors.forename: Weesam
authors.initials: W
authors.lastname: Alkhatib
authors.forename: Carol
authors.initials: C
authors.lastname: Connor
authors.forename: Fan
authors.initials: F
authors.lastname: Fang
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy