title: The predictive value of increased sentinel lymph node volume in breast cancer.
abstract: BACKGROUND
  Breast cancer sentinel lymph nodes (SLNs) with metastases (mets) are often palpably enlarged. We hypothesized that the volume of the SLN and the size of mets are directly related. SLNs harboring mets are often firm, with increased intra-nodal pressure (INP), and we hypothesized that SLN volume, as well as INP, would correlate directly with SLN metastasis size.
  
  
  METHODS
  The SLN volume, INP and met size were measured in 296 SLNs and compared using linear regression analysis. The SLNs were subsequently grouped based upon pN stage. SLN INP and volume were compared between these resultant groups.
  
  
  RESULTS
  Increased SLN volume significantly predicted increased SLN met size on univariate and multivariate analysis (p = 0.001 and p = 0.011, respectively). SLN met size predicted increased SLN INP on both univariate and multivariate analysis (both p = 0.001). SLN volume only significantly correlated with increased SLN INP on univariate analysis (p = 0.001). On subgroup analysis of nodal disease, pN1/2/3 nodes (SLN met sizes >2 mm) were significantly larger (p = 0.039 and p = 0.003, respectively) than pN0 and pN1(mi) nodes, and had significantly increased INP (all p = 0.001) as compared to pN0, pN0(i+), and pN1(mi) nodes.
  
  
  CONCLUSIONS
  SLN volume and INP increased with increasing SLN met size. The threshold met size for this increase was >2 mm (pN1 disease).
authors: Department of Surgery, Washington University School of Med., St. Louis, MO, United States.
authors: B A
authors: BA
authors: Krasnick
authors: Department of Surgery, Henry Ford Health System, Detroit, MI, United States. Electronic address: dnathan1@hfhs.org.
authors: S D
authors: SD
authors: Nathanson
authors: Department of Surgery, Loma Linda University Med. Center, Loma Linda, CA, United States.
authors: C N
authors: CN
authors: Arbabi
authors: Department of Pathology, Henry Ford Health System, Detroit, MI, United States.
authors: D A
authors: DA
authors: Chitale
authors: Department of Public Health, Division of Biostatistics, Henry Ford Health System, Detroit, MI, United States.
authors: E L
authors: EL
authors: Peterson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology* / Q000601:surgery; D018275:Carcinoma, Lobular / Q000473:pathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D011379:Prognosis; D000071036:Sentinel Lymph Node / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
keywords: Breast cancer; Metastasis; Pressure; Sentinel lymph node; Volume