E-ISSN 2587-0831
Original Article
Factors Influencing Non-sentinel Node Metastasis in Patients with Macrometastatic Sentinel Lymph Node Involvement and Validation of Three Commonly Used Nomograms
1 Department of General Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey  
Eur J Breast Health 2017; 13: 189-193
DOI: 10.5152/ejbh.2017.3545
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Key Words: Breast cancer, sentinel node, non-sentinel node metastasis, nomogram
Abstract

Objective: Omitting axillary lymph node dissection (ALND) in a subgroup of patients with sentinel lymph node (SLN) metastasis is becoming a widely accepted practice. Avoiding the well-known complications of ALND is the sole aim without compromising the curative intention of surgery. 

 

Materials and methods: The data were probed for breast cancer patients that were operated on between February 2014 and June 2016. SLN biopsies were performed in 507 patients and out of 157 patients who underwent ALND for a metastatic SLN, 151 were found eligible for the analyses as having macrometastatic (>2mm) SLN. MD Anderson, Memorial Sloan Kettering Cancer Center and Helsinki nomograms were also tested in our patient population.

 

Results: Pathologic tumor size greater than 2 cm, the ratio of metastatic SLN to dissected SLN, metastatic tumor greater than 1 cm and tumors that extended outside the SLN’s capsule were found to be associated with non-sentinel node metastasis in both univariate and multivariate tests. MD Anderson nomogram performed well with an area under the curve (AUC) value of 0.72.

 

 

Conclusion: Our results suggest that ALND should be considered in patients with macrometastatic SLN greater than 10 mm in size, have extracapsular extension, have metastatic SLNs at a rate of more than 50% and whose primary tumor is greater than 2 cm. 

 

 

Cite this article as: Güven HE, Doğan L, Kültüroğlu MO, Gülçelik ME, Özaslan C. Factors Influencing Non-Sentinel Node Metastasis in Patients with Macrometastatic Sentinel Lymph Node Involvement and Validation of Three Commonly Used Nomograms. Eur J Breast Health 2017; 13: 189-193.

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