title: Clinicopathological characteristics of breast cancers with axillary skip metastases.
abstract: OBJECTIVE
  The presence of discontinuous or "skip" metastases in breast cancer is crucial for determining the optimal therapeutic choice. In this study, we compared the clinicopathological characteristics and prognosis of patients with or without skip metastases (SMs).
  
  
  METHODS
  We retrospectively analyzed the records of 1,502 breast cancer patients who underwent radical mastectomy and a separate group of 118 patients who had sentinel lymph node biopsies (SLNB). The median follow-up time was 10 years.
  
  
  RESULTS
  Axillary lymph nodes (ALN) were involved in 814/1502 patients, and SMs was found in 119 patients (14.6%). Age, tumor size, location, clinical stage, and the proportion of interpectoral lymph node (IPN) metastases were similar in patients with or without SMs (p > .05). In stage I and II disease, the event-free survival rate of patients with SMs was significantly lower than patients without (p < .05); there was no significant difference in stage III patients (p > .05). The Cox multivariate analysis showed that the tumor size, number of lymphatic metastases, lymph node involvement, and SMs were important prognostic factors. The false-negative rate of SLNB was 12.0% (3/25).
  
  
  CONCLUSIONS
  Axillary lymphatic SM is difficult to predict, but their presence can predict a poorer prognosis for stage I and II patients. SM could occur in SLNB-negative patients.
authors.affiliation: Department of Breast Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital,   Hexi District, Tianjin,   China.
authors.forename: Jingyan
authors.initials: J
authors.lastname: Sun
authors.forename: Jian
authors.initials: J
authors.lastname: Yin
authors.forename: Liansheng
authors.initials: L
authors.lastname: Ning
authors.forename: Juntian
authors.initials: J
authors.lastname: Liu
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.forename: Lin
authors.initials: L
authors.lastname: Gu
authors.forename: Li
authors.initials: L
authors.lastname: Fu
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002681:China / Q000453:epidemiology; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D015409:Mastectomy, Radical; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy