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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.

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 - J Clin Med Res (2015)

Bottom Line: Statistical analyses were performed using the Mann-Whitney and Chi-square tests, with statistical significance set at P < 0.05.Non-SLN metastasis was associated with invasive tumor size (P = 0.015) and lymphatic involvement (P = 0.035).Large tumor size and the presence of lymphatic involvement were significantly associated with non-SLN metastasis.

View Article: PubMed Central - PubMed

Affiliation: Division of Digestive & General Surgery, Niigata University Graduate School of Medical & Dental Sciences, 1-757 Asahimachi, Niigata, Niigata 951-8510, Japan.

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.

No MeSH data available.


Related in: MedlinePlus

Association between invasive tumor size and non-sentinel lymph node (SLN) metastasis (n = 44). Invasive tumor size was significantly larger in patients who were positive for non-SLN metastasis compared with those who were negative (median size 35.0 vs. 20 mm, respectively; P = 0.020).
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Figure 1: Association between invasive tumor size and non-sentinel lymph node (SLN) metastasis (n = 44). Invasive tumor size was significantly larger in patients who were positive for non-SLN metastasis compared with those who were negative (median size 35.0 vs. 20 mm, respectively; P = 0.020).

Mentions: Conversely, median invasive tumor size was significantly larger in patients who were positive for non-SLN metastasis compared with metastasis negative patients (35.0 vs. 20 mm, respectively; P = 0.020; Fig. 1). However, there was no significant association between non-SLN metastasis and invasive tumor size if the cut-off point was 20 mm. Therefore, we invastigated the threshold value for invasive tumor size that differentiated patients with non-SLN metastasis using ROC analysis. ROC analysis identified a cut-off point of 28 mm (AUC 0.709; sensitivity 64.7%; specificity 25.9%; P = 0.021; Fig. 2). We then used this cut-off point of 28 mm to reassess patients. As indicated in Table 2, using a cut-off value of 28 mm resulted in a significant association between invasive tumor size and non-SLN metastasis (P = 0.015).


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.

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 - J Clin Med Res (2015)

Association between invasive tumor size and non-sentinel lymph node (SLN) metastasis (n = 44). Invasive tumor size was significantly larger in patients who were positive for non-SLN metastasis compared with those who were negative (median size 35.0 vs. 20 mm, respectively; P = 0.020).
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4471749&req=5

Figure 1: Association between invasive tumor size and non-sentinel lymph node (SLN) metastasis (n = 44). Invasive tumor size was significantly larger in patients who were positive for non-SLN metastasis compared with those who were negative (median size 35.0 vs. 20 mm, respectively; P = 0.020).
Mentions: Conversely, median invasive tumor size was significantly larger in patients who were positive for non-SLN metastasis compared with metastasis negative patients (35.0 vs. 20 mm, respectively; P = 0.020; Fig. 1). However, there was no significant association between non-SLN metastasis and invasive tumor size if the cut-off point was 20 mm. Therefore, we invastigated the threshold value for invasive tumor size that differentiated patients with non-SLN metastasis using ROC analysis. ROC analysis identified a cut-off point of 28 mm (AUC 0.709; sensitivity 64.7%; specificity 25.9%; P = 0.021; Fig. 2). We then used this cut-off point of 28 mm to reassess patients. As indicated in Table 2, using a cut-off value of 28 mm resulted in a significant association between invasive tumor size and non-SLN metastasis (P = 0.015).

Bottom Line: Statistical analyses were performed using the Mann-Whitney and Chi-square tests, with statistical significance set at P < 0.05.Non-SLN metastasis was associated with invasive tumor size (P = 0.015) and lymphatic involvement (P = 0.035).Large tumor size and the presence of lymphatic involvement were significantly associated with non-SLN metastasis.

View Article: PubMed Central - PubMed

Affiliation: Division of Digestive & General Surgery, Niigata University Graduate School of Medical & Dental Sciences, 1-757 Asahimachi, Niigata, Niigata 951-8510, Japan.

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.

No MeSH data available.


Related in: MedlinePlus