title: p53 expression in breast cancer predicts tumors with low probability of non-sentinel nodes infiltration.
abstract: OBJECTIVE
  Several predictive tools of non-sentinel lymph nodes neoplastic involvement when a positive sentinel lymph node is found have been described. However, molecular factors have been rarely evaluated to build these tools. The aim of this study was to establish which factors predicted non-sentinel lymph nodes infiltration in our setting, including some molecular factors.
  
  
  METHODS
  We carried out a retrospective review of 161 patients with breast cancer and a positive sentinel lymph node who had undergone axillary lymph node dissection, none of whom had received neoadjuvant treatment. Features evaluated as predictive factors for non-sentinel node positivity were: menopausal status, tumor size, histological subtype, histological grade, lymphovascular invasion, extracapsular invasion, Ki67 index, hormonal receptors, CerbB2 and p53 expression, size of sentinel lymph node metastases and number of sentinel lymph nodes affected.
  
  
  RESULTS
  Tumor size (P = 0.001), size of sentinel lymph node metastases (P = 0.001), lobular invasive carcinoma (P = 0.05) and lymphovascular invasion (P = 0.006) were significantly associated with non-sentinel lymph node positivity. Tumor p53 positive expression was strongly associated with non-sentinel lymph node negativity (P = 0.000). In multivariate analysis, all these factors but tumor size maintained their significance. The discrimination power of the model calculated by the area under the receiver-operator curve was 0.811 (95% confidence interval, 0.741-0.880).
  
  
  CONCLUSIONS
  p53 expression in breast cancer was highly predictive of non-sentinel lymph node negativity in our study. New studies should evaluate if it would be useful to add p53 expression to other existing predictive tools.
authors: Obstetrics and Gynecology Department, Hospital del Mar, Bellaterra, Spain.|Breast Surgery, Breast Functional Unit, Hospital del Mar, Bellaterra, Spain.|Universitat Autònoma de Barcelona, Bellaterra, Spain.
authors: Maria
authors: M
authors: Vernet-Tomás
authors: Obstetrics and Gynecology Department, Hospital del Mar, Bellaterra, Spain.
authors: Nuria
authors: N
authors: Baños
authors: Obstetrics and Gynecology Department, Hospital del Mar, Bellaterra, Spain.|Breast Surgery, Breast Functional Unit, Hospital del Mar, Bellaterra, Spain.
authors: Dolors
authors: D
authors: Sabadell
authors: Pathology Department, Hospital del Mar, Bellaterra, Spain.|Universitat Autònoma de Barcelona, Bellaterra, Spain.
authors: Josep-Maria
authors: JM
authors: Corominas
authors: Nuclear Medicine Department, Hospital del Mar, Bellaterra, Spain.
authors: Antoni
authors: A
authors: Mestre-Fusco
authors: Nuclear Medicine Department, Hospital del Mar, Bellaterra, Spain.
authors: Marina
authors: M
authors: Suárez-Piñera
authors: Obstetrics and Gynecology Department, Hospital del Mar, Bellaterra, Spain.|Universitat Autònoma de Barcelona, Bellaterra, Spain.
authors: Ramon
authors: R
authors: Carreras
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013030:Spain; D047368:Tumor Burden; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53
keywords: axillary lymph node dissection; non-sentinel lymph node; p53; sentinel lymph node