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Toshikawa C, Koyama Y, Nagahashi M, et al. Predictive Factors for Non-Sentinel Lymph Node Metastasis in the Case of Positive Sentinel Lymph Node Metastasis in Two or Fewer Nodes in Breast Cancer. J Clin Med Res. 2015;7(8):620-6doi: 10.14740/jocmr2195w.
Toshikawa, C., Koyama, Y., Nagahashi, M., Tatsuda, K., Moro, K., Tsuchida, J., Hasegawa, M., Niwano, T., Manba, N., Ikarashi, M., Kameyama, H., Kobayashi, T., Kosugi, S., & Wakai, T. (2015). Predictive Factors for Non-Sentinel Lymph Node Metastasis in the Case of Positive Sentinel Lymph Node Metastasis in Two or Fewer Nodes in Breast Cancer. Journal of clinical medicine research, 7(8), 620-6. https://doi.org/10.14740/jocmr2195w
Toshikawa, Chie, et al. "Predictive Factors for Non-Sentinel Lymph Node Metastasis in the Case of Positive Sentinel Lymph Node Metastasis in Two or Fewer Nodes in Breast Cancer." Journal of clinical medicine research vol. 7,8 (2015): 620-6. doi: https://doi.org/10.14740/jocmr2195w
Toshikawa C, Koyama Y, Nagahashi M, Tatsuda K, Moro K, Tsuchida J, Hasegawa M, Niwano T, Manba N, Ikarashi M, Kameyama H, Kobayashi T, Kosugi S, Wakai T. Predictive Factors for Non-Sentinel Lymph Node Metastasis in the Case of Positive Sentinel Lymph Node Metastasis in Two or Fewer Nodes in Breast Cancer. J Clin Med Res. 2015 Aug;7(8):620-6. doi: 10.14740/jocmr2195w. Epub 2015 Jun 09. PMID: 26124908; PMCID: PMC4471749.
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J Clin Med Res. 2015 Aug;7(8):620-6. doi: 10.14740/jocmr2195w. Epub 2015 Jun 09.

Predictive Factors for Non-Sentinel Lymph Node Metastasis in the Case of Positive Sentinel Lymph Node Metastasis in Two or Fewer Nodes in Breast Cancer.

Journal of clinical medicine research

Chie Toshikawa, Yu Koyama, Masayuki Nagahashi, Kumiko Tatsuda, Kazuki Moro, Junko Tsuchida, Miki Hasegawa, Toshiyuki Niwano, Naoko Manba, Mayuko Ikarashi, Hitoshi Kameyama, Takashi Kobayashi, Shin-Ichi Kosugi, Toshifumi Wakai

Affiliations

  1. Division of Digestive & General Surgery, Niigata University Graduate School of Medical & Dental Sciences, 1-757 Asahimachi, Niigata, Niigata 951-8510, Japan.
  2. Division of Digestive & General Surgery, Niigata University Graduate School of Medical & Dental Sciences, 1-757 Asahimachi, Niigata, Niigata 951-8510, Japan ; Department of Nursing, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi, Niigata, Niigata 951-8518, Japan.
  3. Division of Digestive & General Surgery, Niigata University Graduate School of Medical & Dental Sciences, 1-757 Asahimachi, Niigata, Niigata 951-8510, Japan ; Department of Digestive and General Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata 949-7302, Japan.

PMID: 26124908 PMCID: PMC4471749 DOI: 10.14740/jocmr2195w

Abstract

BACKGROUND: In breast cancer, recent clinical trials have shown that sentinel lymph node biopsy (SLNB) alone without axillary lymph node dissection results in excellent prognosis if there is sentinel lymph node (SLN) metastasis in two or fewer nodes. The aim of the present study was to investigate the association between non-SLN metastasis and clinicopathological factors in case of SLN metastasis in two or fewer nodes in breast cancer.

METHODS: Patients who underwent SLNB for invasive breast cancer and were found to have positive SLN in two or fewer nodes were evaluated. The associations between non-SLN metastasis and clinicopahological factors were examined. Statistical analyses were performed using the Mann-Whitney and Chi-square tests, with statistical significance set at P < 0.05.

RESULTS: A total of 358 patients were enrolled during the study period and all of these patients were female and 54 patients had SLN metastasis (15%). Positive SLN in two or fewer nodes was identified in 44 patients (81.5%). Among these patients, 17 (38.6%) were found to have non-SLN metastasis. Non-SLN metastasis was associated with invasive tumor size (P = 0.015) and lymphatic involvement (P = 0.035). Multivariate analysis showed that tumor size (P = 0.011) and lymphatic involvement (P = 0.019) remained significant independent predictors of non-SLN metastasis, and that an invasive tumor size cut-off point of 28 mm was useful for dividing patients with positive SLN in two or fewer nodes into non-SLN-positive and non-SLN-negative groups.

CONCLUSIONS: Non-SLN metastasis was found in more than 30% of patients with SLN metastasis present in two or fewer nodes. Large tumor size and the presence of lymphatic involvement were significantly associated with non-SLN metastasis.

Keywords: Breast cancer; Invasive tumor size; Lymphatic involvement; Metastasis; Non-sentinel lymph node; Sentinel lymph node

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