title: Role of patient and tumor characteristics in sentinel lymph node metastasis in patients with luminal early breast cancer: an observational study.
abstract: Predicting the risk of sentinel lymph node (SLN) metastasis is important for clinical decision-making in the setting of early breast cancer (EBC). This study is aimed to identify tumor and patient characteristics that influenced the SLN metastatic involvement, with a focus on luminal subtypes. An observational study including women treated for EBC from 2005 to 2013 was conducted. Regression analyses were used to assess the association between SLN metastasis and age, menopausal status, tumor size, histological grading, presence of extensive "in situ" carcinoma components, lymphovascular invasion (LVI), and expression of Ki-67, hormone receptors, and HER2. Of 345 women, 84 (24.3 %) had at least one SLN metastasis; 63.1 % were macrometastases. Among all patients, 31.6 % exhibited LVI. In univariate analyses, tumor size, histological grade, and LVI were associated with SLN metastasis. The multivariate model confirmed only the association between LVI and SLN status (OR 3.27, 95 % CI 1.85-5.68; p < 0.0001). Luminal subtypes were detected in 86.1 % of women. In this subgroup, the multivariate model confirmed a significant relationship between LVI and SLN status (OR 3.47, 95 % CI 1.90-6.33; p < 0.0001). Since a proper histopathological assessment of LVI is not possible prior to surgery, this factor cannot be used to guide decisions on performing SLN biopsies. Nevertheless, when a SLN biopsy is refused or contraindicated, an LVI assessment on an excisional biopsy of the tumor could facilitate prognosis determination and treatment management.
authors.affiliation: Oncology Department, Fatebenefratelli and Oftalmico Hospital, Corso di Porta Nuova 23, 20121 Milan, Italy.
authors.forename: Nicla
authors.initials: N
authors.lastname: La Verde
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via La Masa 19, 20156 Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Biagioli
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via La Masa 19, 20156 Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Gerardi
authors.affiliation: Oncology Department, Fatebenefratelli and Oftalmico Hospital, Corso di Porta Nuova 23, 20121 Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cordovana
authors.affiliation: Oncology Department, Fatebenefratelli and Oftalmico Hospital, Corso di Porta Nuova 23, 20121 Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Casiraghi
authors.affiliation: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via La Masa 19, 20156 Milan, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Floriani
authors.affiliation: Oncology Department, Fatebenefratelli and Oftalmico Hospital, Corso di Porta Nuova 23, 20121 Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bernardin
authors.affiliation: Oncology Department, Fatebenefratelli and Oftalmico Hospital, Corso di Porta Nuova 23, 20121 Milan, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Farina
authors.affiliation: IRCCS - Istituto Nazionale Tumori, Via Venezian 1, 20133 Milan, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Di Cosimo
authors.affiliation: Oncology Department, Fatebenefratelli and Oftalmico Hospital, Corso di Porta Nuova 23, 20121 Milan, Italy.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Dazzani
authors.affiliation: Oncology Department, Fatebenefratelli and Oftalmico Hospital, Corso di Porta Nuova 23, 20121 Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gherardi