Sentinel Node Ratio as a Predictor of Non-sentinel Lymph Node Involvement
Background: Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) in early breast cancer patients as the first line surgical approach to axillary nodes. Further dissection is performed only when SLN is involved by tumor cells. However, in a significant proportion of pa...
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| Format: | Article |
| Language: | English |
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Kaviani Breast Disease Institute
2014-11-01
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| Series: | Archives of Breast Cancer |
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| Online Access: | https://archbreastcancer.com/index.php/abc/article/view/18 |
| _version_ | 1818143937166049280 |
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| author | Reza Parsaei Ramesh Omranipour Fezzeh Elyasinia Farham Ahmadi Khatereh Jamei Fatemeh Sabri Mohamadreza Neishaboury Ahmad Kaviani |
| author_facet | Reza Parsaei Ramesh Omranipour Fezzeh Elyasinia Farham Ahmadi Khatereh Jamei Fatemeh Sabri Mohamadreza Neishaboury Ahmad Kaviani |
| author_sort | Reza Parsaei |
| collection | DOAJ |
| description | Background: Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) in early breast cancer patients as the first line surgical approach to axillary nodes. Further dissection is performed only when SLN is involved by tumor cells. However, in a significant proportion of patients, non-sentinel nodes are still not involved and axillary dissection has no additional therapeutic benefits. Selective axillary clearance has been considered to prevent unnecessary dissection. The purpose of this study was to define predictors of non-sentinel lymph node involvement in patients with positive SLNB.
Methods: Patients with early stage breast cancer and positive SLNB who underwent ALNDin a referral hospital in Tehran, Iran between2010 and 2012 were recruited into the study. Relations between different clinico-pathological characteristics and involvement of non-sentinel nodes were investigated.
Results: From 139 patients who had positive SLNB and underwent ALND, only in 71 cases (51%) positive non-sentinel lymph nodes (NSLNs) were detected. In univariate analysis, there was no association between tumor size, lymphovascular invasion, ER, PR and HER-2 expression and NSLN metastasis. In contrast, presence of more than one SLN (P = 0.016) and a sentinel node ratio (SNR) more than 0.5 showed a significant association (P< 0.001). Only the latter remained as the significant predictor of NSLN involvement in mutltivariate analysis (P < 0.001, OR = 3.706).
Conclusions: Based on our results, patients with a SNR more than 0.5 were more commonly diagnosed with NSLN metastasis. Thus, it is recommended that surgeons think twice before skipping ALND in this subgroup of patients. |
| first_indexed | 2024-12-11T11:39:36Z |
| format | Article |
| id | doaj.art-11d5480dabd24b76b43316a9d943aafe |
| institution | Directory Open Access Journal |
| issn | 2383-0433 |
| language | English |
| last_indexed | 2024-12-11T11:39:36Z |
| publishDate | 2014-11-01 |
| publisher | Kaviani Breast Disease Institute |
| record_format | Article |
| series | Archives of Breast Cancer |
| spelling | doaj.art-11d5480dabd24b76b43316a9d943aafe2022-12-22T01:08:39ZengKaviani Breast Disease InstituteArchives of Breast Cancer2383-04332014-11-011310.19187/abc.20141381-8518Sentinel Node Ratio as a Predictor of Non-sentinel Lymph Node InvolvementReza Parsaei0Ramesh Omranipour1Fezzeh Elyasinia2Farham Ahmadi3Khatereh Jamei4Fatemeh Sabri5Mohamadreza Neishaboury6Ahmad Kaviani7Department of Surgery, Tehran University of Medical Sciences, Tehran, IranDepartment of Surgery, Tehran University of Medical Sciences, Tehran, IranDepartment of Surgery, Tehran University of Medical Sciences, Tehran, IranDepartment of Surgery, Tehran University of Medical Sciences, Tehran, IranKaviani Breast Diseases Institute, Tehran, IranKaviani Breast Diseases Institute, Tehran, IranDepartment of Surgery, Tehran University of Medical Sciences, Tehran, IranDepartment of Surgery, Tehran University of Medical Sciences, Tehran, IranBackground: Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) in early breast cancer patients as the first line surgical approach to axillary nodes. Further dissection is performed only when SLN is involved by tumor cells. However, in a significant proportion of patients, non-sentinel nodes are still not involved and axillary dissection has no additional therapeutic benefits. Selective axillary clearance has been considered to prevent unnecessary dissection. The purpose of this study was to define predictors of non-sentinel lymph node involvement in patients with positive SLNB. Methods: Patients with early stage breast cancer and positive SLNB who underwent ALNDin a referral hospital in Tehran, Iran between2010 and 2012 were recruited into the study. Relations between different clinico-pathological characteristics and involvement of non-sentinel nodes were investigated. Results: From 139 patients who had positive SLNB and underwent ALND, only in 71 cases (51%) positive non-sentinel lymph nodes (NSLNs) were detected. In univariate analysis, there was no association between tumor size, lymphovascular invasion, ER, PR and HER-2 expression and NSLN metastasis. In contrast, presence of more than one SLN (P = 0.016) and a sentinel node ratio (SNR) more than 0.5 showed a significant association (P< 0.001). Only the latter remained as the significant predictor of NSLN involvement in mutltivariate analysis (P < 0.001, OR = 3.706). Conclusions: Based on our results, patients with a SNR more than 0.5 were more commonly diagnosed with NSLN metastasis. Thus, it is recommended that surgeons think twice before skipping ALND in this subgroup of patients.https://archbreastcancer.com/index.php/abc/article/view/18Sentinel lymph node rationon-sentinel lymph nodeaxillary dissection |
| spellingShingle | Reza Parsaei Ramesh Omranipour Fezzeh Elyasinia Farham Ahmadi Khatereh Jamei Fatemeh Sabri Mohamadreza Neishaboury Ahmad Kaviani Sentinel Node Ratio as a Predictor of Non-sentinel Lymph Node Involvement Archives of Breast Cancer Sentinel lymph node ratio non-sentinel lymph node axillary dissection |
| title | Sentinel Node Ratio as a Predictor of Non-sentinel Lymph Node Involvement |
| title_full | Sentinel Node Ratio as a Predictor of Non-sentinel Lymph Node Involvement |
| title_fullStr | Sentinel Node Ratio as a Predictor of Non-sentinel Lymph Node Involvement |
| title_full_unstemmed | Sentinel Node Ratio as a Predictor of Non-sentinel Lymph Node Involvement |
| title_short | Sentinel Node Ratio as a Predictor of Non-sentinel Lymph Node Involvement |
| title_sort | sentinel node ratio as a predictor of non sentinel lymph node involvement |
| topic | Sentinel lymph node ratio non-sentinel lymph node axillary dissection |
| url | https://archbreastcancer.com/index.php/abc/article/view/18 |
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