title: Prediction of nonsentinel lymph node metastasis in breast cancer patients with one or two positive sentinel lymph nodes.
abstract: OBJECTIVE
  The aim of the present study was to investigate the association between non sentinel lymph node metastasis (NSLNM) and clinicopathological factors, particularly in the case of sentinel lymph node (SLN) metastasis in one or two, in clinically node negative patients with breast cancer.
  
  
  METHODS
  Between 10/2010 and 10/2014, 350 sentinel lymph node biopsy (SLNB) were performed in patients with histologically proven primary breast cancer in our clinic. The data collection includes the following characteristics: age, pathological tumor size, histological type, histological grade, lymphovascular invasion (LVI), number of positive SLN, size of the SLN metastasis (macrometastasis, micrometastasis, isolated tumor cells), multifocality (MF), extracapsuler invasion (ECI) of the SLN, the estrogen receptor (ER) status, the progesterone receptor (PR) status and the Her 2 receptor status, Ki 67 reseptor status. Data were collected retrospectively and then analyzed.
  
  
  RESULTS
  A successful SLN biopsy were performed in 345 (98.5%) cases. SLN metastases were detected in 110 (31.8%) cases. These patients then underwent axillary dissection; among these patients, 101 (91.8%) had only one to two positive SLNs. Of the 101 patients with positive SLN biopsies, 32 (31.6%) had metastases in the NSLNs. Univariate and multivariate analysis showed that lymphovascular invasion, extracapsular invasion (ECI), Her-2 receptor positive, and Ki-67 > 14% were related to NSLNM (p<.0.05).
  
  
  CONCLUSIONS
  The predicting factors of NSLNM were LVI, ECI, Ki-67 level, Her-2 reseptor positive and but should be further validated in our institutions, different institutions and different patient groups prospectively.
authors: Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey. Electronic address: drbahadir01@gmail.com.
authors: Bahadır
authors: B
authors: Öz
authors: Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Alper
authors: A
authors: Akcan
authors: Department of Radiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Serap
authors: S
authors: Doğan
authors: Department of Nuclear Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Ümmühan
authors: Ü
authors: Abdulrezzak
authors: Department of Radiation Oncology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Dicle
authors: D
authors: Aslan
authors: Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Erdoğan
authors: E
authors: Sözüer
authors: Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Ertan
authors: E
authors: Emek
authors: Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Muhammet
authors: M
authors: Akyüz
authors: Department of Biostatistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Ferhan
authors: F
authors: Elmalı
authors: Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors: Engin
authors: E
authors: Ok
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D012189:Retrospective Studies; D000071036:Sentinel Lymph Node; D021701:Sentinel Lymph Node Biopsy
keywords: Her-2 status; Ki-67; breast cancer; clinically node negative; extracapsuler invasion; non sentinel lymph node