Risk Factors for Non-Sentinel Lymph Node Metastases in Patients with Breast Cancer. The Outcome of a Multi-institutional Study

Abstract

We identified three predictive factors for non-SN metastases in breast cancer patients with a positive SN: size of the SN metastasis; primary tumor size; and vessel invasion. We were not able to identify a specific group of patients with a positive SN in whom the risk for non-SN metastases was less than 5%.

Increased Sentinel Lymph Node Lymphangiogenesis is Associated with Nonsentinel Axillary Lymph Node Involvement in Breast Cancer Patients with a Positive Sentinel Node

“…The median number of nonsentinel axillary LNs resected was 13 (3 -29). Metastatic involvement of at least one nonsentinel axillary LN was found in 37 of 65 (56.9%) patients, with the median number of involved nonsentinel axillary LNs being 3 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Neither the size of the primary tumor, nor Nottingham grade, nor estrogen receptor, progesterone receptor, or Her2 status, nor the involvement of more than one sentinel LN, were correlated with the presence of nonsentinel LN metastases.…”

“…The size of the sentinel LN metastasis has emerged as a most powerful independent predictor in several studies (3 -15). Furthermore, the number of involved sentinel LNs (3,4,7,10,11,16), extracapsular growth of the sentinel LN metastasis (3,6,15), the size of the primary tumor (7,9,10,13,14), and the presence of lymphovascular invasion (4,7,9,14,15) have also been associated with metastatic involvement of nonsentinel axillary LNs. Based on these factors and on other clinicopathologic variables, Van Zee et al developed a nomogram to predict the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel node biopsy (17).…”

A New and Simple Predictive Formula for Non-Sentinel Lymph Node Metastasis in Breast Cancer Patients with Positive Sentinel Lymph Nodes, and Validation of 3 Different Nomograms in Turkish Breast Cancer Patients

“…With the rapid increase in patient numbers, the SLNB technique proved to protect nearly half of all patients from unnecessary AD, and moreover it was shown that the SLN was the only involved node in up to 50-65% of the remaining patients. Setting out from these data, studies were launched worldwide to determine factors affecting SLN and NSLN involvement [14][15][16], which resulted in the establishment of a number of nomograms. The results of our study highlight these facts once again.…”

Factors predicting non-sentinel lymph node involvement in sentinel node positive breast carcinoma

“…The size of the metastatic tumor in SNs has been proven to be a predictor of non-SN involvement by many studies using multivariate analyses (6,7,15,17,18). Other factors considering tumor burden in SNs, such as percent replacement of SN by tumor, the number of positive SNs, the proportion of involved SNs among all identified SNs, and presence of extracapsular extension have also been shown to be predictors of non-SN involvement by different studies (2,8,(10)(11)(12)17,(19)(20)(21)(22).…”