title: What are the preoperative factors that can determine the presence of metastases in other axillary nodes in breast cancer when the sentinel node is positive?
abstract: OBJECTIVE
  To determine whether preoperative factors, such as size of metastases in the sentinel lymph node (SLN), number of positive SLNs (1, >1), tumoral grade, lymphovascular invasion (LVI) and tumoral size can predict the presence of metastases in non-SLNs, when the SLN is positive.
  
  
  METHODS
  The study population was 1 146 breast cancer patients. Lymphadenectomy was performed in 150. Three groups of patients were established depending on the size of the metastases in SLNs: group A: <2 mm; group B: 2 < or =GC < or =5 mm; group C: > 5 mm. Either the chi(2) test or Fisher's test was performed to compare categorical variables, and a multivariate conditional logistic regression model for data sets was performed to identify the deterministic factors of metastases presence.
  
  
  RESULTS
  Ten percent of group A, 28% of group B and 52% of group C presented non-SLN metastases. Patients with >1 positive-SLN presented significantly more non-SLN metastases than those with only one positive-SLN; 56% of patients with LVI presented non-SLN metastases versus 26% of those without LVI. The tumoral grade and size did not seem to have any influence on the number of patients with non-SLN metastases. The number of positive-SLNs and size of metastases were statistically associated with the presence of metastases.
  
  
  CONCLUSIONS
  In this study population, the probability of finding non-SLN metastases was statistically related to the size of the SLN metastases and the number of positive-SLNs.
authors.affiliation: Department of Nuclear Medicine, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain. 38369adv@comb.es
authors.forename: A
authors.initials: A
authors.lastname: Domènech
authors.forename: A
authors.initials: A
authors.lastname: Benítez
authors.forename: M T
authors.initials: MT
authors.lastname: Bajén
authors.forename: Y
authors.initials: Y
authors.lastname: Ricart
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez-Gasén
authors.forename: J A
authors.initials: JA
authors.lastname: Palacín
authors.forename: I
authors.initials: I
authors.lastname: Català
authors.forename: M
authors.initials: M
authors.lastname: Gil
authors.forename: S
authors.initials: S
authors.lastname: Pernas
authors.forename: A
authors.initials: A
authors.lastname: García
authors.forename: J
authors.initials: J
authors.lastname: Martín-Comín
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D011300:Preoperative Care / Q000706:statistics & numerical data; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D013030:Spain / Q000453:epidemiology