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The diameter of metastasis in positive sentinel lymph node biopsy affects axillary tumor load in early breast cancer
Author(s) -
Falco Michał,
Masojć Bartłomiej,
Byrski Tomasz,
Kram Andrzej
Publication year - 2019
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.13113
Subject(s) - lymph , sentinel lymph node , medicine , breast cancer , axillary lymph node dissection , biopsy , axillary lymph nodes , metastasis , axilla , primary tumor , pathology , radiology , cancer
Omission of axillary lymph node dissection (ALND) after positive sentinel lymph biopsy (SLNB) has become a standard procedure for breast cancer patients with one or two metastatic lymph nodes. Here the aim was model development for selection for ALND. Material and methods We analyzed 323 positive SLNB breast cancer patients, who afterwards underwent ALND. In 126 (39%), there were positive additional axillary lymph nodes. Specimens of resected lymph nodes were scanned and the volumes of tumors (expressed as diameter in mm) were calculated. The maximal diameter of metastasis in the sentinel lymph nodes (SLN Dmax ) and axillary lymph nodes (ALN Dsum ) indicated tumor load in the resected lymph nodes. ALN Dsum higher or equal to 5 mm was defined as high and present in 62 patients (21%). Results Risk factors for high ALN Dsum were primary tumor diameter ( P = 0.0092), histopathological type ( P = 0.0173), number of positive SLNs ( P = 0.0012), type of metastasis ( P = 0.0025), molecular type ( P = 0.0037), SLN Dmax ( P = 0.0001), and Her‐2 status ( P = 0.0093). Independent variables for high ALN Dsum were SLN Dmax ( P < 0.0001), number of positive SLNs ( P = 0.0237) and primary tumor diameter ( P = 0.0296). Conclusions Twenty‐one percent patients with positive SLNB are at risk of high ALN Dsum . SLN Dmax is the strong predictive factor for high ALN Dsum after positive ALND.