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. 2018 Aug;15(3):282-289.
doi: 10.20892/j.issn.2095-3941.2018.0023.

Analysis of factors related to non-sentinel lymph node metastasis in 296 sentinel lymph node-positive Chinese breast cancer patients

Amina Maimaitiaili  1 , Di Wu  1 , Zhenyu Liu  1 , Haimeng Liu  1 , Xiamusiye Muyiduli  2 , Zhimin Fan  1
Affiliations

Analysis of factors related to non-sentinel lymph node metastasis in 296 sentinel lymph node-positive Chinese breast cancer patients

Amina Maimaitiaili et al. Cancer Biol Med. 2018 Aug.

Erratum in

Abstract

Objective: Axillary lymph node dissection (ALND) may be unnecessary in 20%-60% of breast cancer patients with sentinel lymph node (NSLN) metastasis. The aim of the present study was to review the medical records of Chinese patients with early-stage breast cancer and positive NSLN metastasis to identify clinicopathological characteristics as risk factors for non-NSLN metastasis.

Methods: The medical records of 2008 early-stage breast cancer patients who received intraoperative sentinel lymph node biopsy (SLNB) between 2006 and 2016 were retrospectively reviewed. These patients were clinically and radiologically lymph node-negative and had no prior history of receiving neoadjuvant chemotherapy or endocrinotherapy. The clinicopathological characteristics of patients with positive NSLN metastasis who underwent ALND were investigated.

Results: In the present study, 296 patients with positive NSLN metastases underwent ALND. Positive non-NSLN metastases were confirmed in 95 patients (32.1%). On univariate analysis, ≥ 3 positive NSLN metastases (P <0.01), NSLN macrometastases ( P = 0.023), and lymphovascular invasion (P = 0.04) were associated with non-NSLN metastasis (P <0.05). In multivariate analysis, the number of positive SLNs was the most significant predictor of non-SLN metastasis. For patients with 0, 1, 2, or 3 associated risk factors, the non-SLN metastatic rates were 11.5%, 22.5%, 35.2%, and 73.1%, respectively.

Conclusions: The number of positive NSLNs, NSLN macrometastases, and lymphovascular invasion were correlated with non-SLN metastasis. The number of positive SLNs was an independent predictor for non-NSLN metastasis. When 2 or 3 risk factors were present in one patient, the probability of non-NSLN was higher than that in the American College of Surgeons Oncology Group Z0011 trial (27.3%); thus, avoiding ALND should be considered carefully.

Keywords: Breast cancer; axillary lymph node dissection; non-sentinel lymph node metastasis; sentinel lymph node metastasis.

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Figures

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1
Schematic representation of nodal status. NSLN transfer ratio: number of NSLN involved/number of NSLN detected.
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2
Non-SLN rates when there are 0 to 3 risk factors. Risk factors include: (1) number of positive SLN ≥3; (2) SLN macrometastases; (3) lymphovascular invasion.
See this image and copyright information in PMC

References

    1. Zuo TT, Zheng RS, Zeng HM, Zhang SW, Chen WQ. Female breast cancer incidence and mortality in China, 2013. Thorac Cancer. 2017;8:214–8. - PMC - PubMed
    1. Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Costantino JP, et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol. 2010;11:927–33. - PMC - PubMed
    1. Meretoja T, Leidenius M. Response. JNCI J Natl Cancer Inst. 2013;105:1514. - PubMed
    1. Dingemans SA, de Rooij PD, van der Vuurst de Vries RM, Budel LM, Contant CM, van der Pool AEM. Validation of six nomograms for predicting non-sentinel lymph node metastases in a Dutch breast cancer population. Ann Surg Oncol. 2016;23:477–81. - PMC - PubMed
    1. Mittendorf EA, Hunt KK, Boughey JC, Bassett R, Degnim AC, Harrell R, et al. Incorporation of sentinel lymph node metastasis size into a nomogram predicting nonsentinel lymph node involvement in breast cancer patients with a positive sentinel lymph node. Ann Surg. 2012;255:109–15. - PMC - PubMed

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