S-classification of sentinel lymph node predicts axillary nonsentinel lymph node status in patients with breast cancer.
BACKGROUND
One-half of breast cancer patients with positive sentinel lymph node (SN) have no further metastases in the axillary lymph node basin. The aim of the present study was to identify patients with positive SN who are unlikely to have further metastases in the axillary lymph node basin, using a new classification of SN, namely the S-classification.


METHODS
Specimens of positive SN were subjected to a pathological review according to the previously published S-classification. S-stages of positive SN were correlated with the status of further metastases in the axillary lymph node basin after axillary lymph node dissection (ALND).


RESULTS
Of 117 patients who underwent sentinel lymph node biopsy, 36 (30.8%) had a positive SN and were subjected to level I and II ALND. The occurrence of positive nonsentinel nodes was significantly related to the S-stage of SN. No patient with stage SI had additional metastases in the nonsentinel lymph nodes, while 14.3% of patients with SII stage disease and 60.9% of patients with SIII disease had other non-SN that were metastatic.


CONCLUSIONS
S-stages of positive SN are highly predictive for axillary nonsentinel node status. Especially patients with SI sentinel node metastases appear to be at low risk for further nonsentinel node metastases.
Department of Dermatology, Wilhelminenspital, Montleartstrasse 37, 1160, Vienna, Austria. astrid.fink@wienkav.at
Astrid Maria
AM
Fink
Harald
H
Lass
Helmut
H
Hartleb
Wolfgang
W
Jurecka
Heinrich
H
Salzer
Andreas
A
Steiner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging / Q000145:classification*; D011237:Predictive Value of Tests; D021701:Sentinel Lymph Node Biopsy