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Factors Predictive of Sentinel Lymph Node Involvement in Primary Breast Cancer.

Abstract Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) for axillary staging in patients with early-stage breast cancer. The need for therapeutic ALND is the subject of ongoing debate especially after the publication of the ACOSOG Z0011 trial. In a retrospective trial with univariate and multivariate analyses, factors predictive of sentinel lymph node involvement should be analyzed in order to define tumor characteristics of breast cancer patients, where SLNB should not be spared to receive important indicators for adjuvant treatment decisions (e.g. thoracic wall irradiation after mastectomy with or without reconstruction).
PMID
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Authors

Mayor MeshTerms
Keywords

Breast cancer

lymph node involvement

predictive factors

sentinel node biopsy

Journal Title anticancer research
Publication Year Start




PMID- 29848724
OWN - NLM
STAT- MEDLINE
DCOM- 20180611
LR  - 20180611
IS  - 1791-7530 (Electronic)
IS  - 0250-7005 (Linking)
VI  - 38
IP  - 6
DP  - 2018 Jun
TI  - Factors Predictive of Sentinel Lymph Node Involvement in Primary Breast Cancer.
PG  - 3657-3662
LID - 10.21873/anticanres.12642 [doi]
AB  - BACKGROUND/AIM: Sentinel lymph node biopsy (SLNB) has replaced axillary lymph
      node dissection (ALND) for axillary staging in patients with early-stage breast
      cancer. The need for therapeutic ALND is the subject of ongoing debate especially
      after the publication of the ACOSOG Z0011 trial. In a retrospective trial with
      univariate and multivariate analyses, factors predictive of sentinel lymph node
      involvement should be analyzed in order to define tumor characteristics of breast
      cancer patients, where SLNB should not be spared to receive important indicators 
      for adjuvant treatment decisions (e.g. thoracic wall irradiation after mastectomy
      with or without reconstruction). PATIENTS AND METHODS: Between 2006 and 2010,
      1,360 patients with primary breast cancer underwent SLNB with/without ALND with
      evaluation of tumor localization, multicentricity and multifocality, histological
      subtype, tumor size, grading, lymphovascular invasion (LVI), and estrogen
      receptor, progesterone receptor and human epidermal growth factor receptor 2
      status. These characteristics were retrospectively analyzed in univariate and
      multivariate logistic regression models to define significant predictive factors 
      for sentinel lymph node involvement. The multivariate analysis demonstrated that 
      tumor size and LVI (p<0.001) were independent predictive factors for metastatic
      sentinel lymph node involvement in patients with early-stage breast cancer.
      CONCLUSION: Because of the increased risk for metastatic involvement of axillary 
      sentinel nodes in cases with larger breast cancer or diagnosis of LVI, patients
      with these breast cancer characteristics should not be spared from SLNB in a
      clinically node-negative situation in order to avoid false-negative results with 
      a high potential for wrong indication of primary breast reconstruction or wrong
      non-indication of necessary post-mastectomy radiation therapy. The prognostic
      impact of avoidance of axillary staging with SLNB is analyzed in the ongoing
      prospective INSEMA trial.
CI  - Copyright(c) 2018, International Institute of Anticancer Research (Dr. George J. 
      Delinasios), All rights reserved.
FAU - Malter, Wolfram
AU  - Malter W
AD  - Breast Center, University Medical Center of Cologne, Cologne, Germany
      [email protected]
FAU - Hellmich, Martin
AU  - Hellmich M
AD  - Institute of Medical Statistics, Informatics and Epidemiology, University Medical
      Center of Cologne, Cologne, Germany.
FAU - Badian, Mayhar
AU  - Badian M
AD  - Western German Breast-Center, DOC Holding GmbH, Dusseldorf, Germany.
FAU - Kirn, Verena
AU  - Kirn V
AD  - Breast Center, University Medical Center of Cologne, Cologne, Germany.
FAU - Mallmann, Peter
AU  - Mallmann P
AD  - Department of Gynaecology and Obstetrics, University Medical Center of Cologne,
      Cologne, Germany.
FAU - Kramer, Stefan
AU  - Kramer S
AD  - Department of Gynaecology and Obstetrics, Helios Hospital Krefeld, Krefeld,
      Germany.
LA  - eng
PT  - Journal Article
PL  - Greece
TA  - Anticancer Res
JT  - Anticancer research
JID - 8102988
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Axilla
MH  - Breast/*pathology
MH  - Breast Neoplasms/*pathology
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Lymph Node Excision/methods
MH  - Lymph Nodes/pathology
MH  - Mastectomy
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Sentinel Lymph Node/*pathology
MH  - Sentinel Lymph Node Biopsy/*methods
MH  - Young Adult
OTO - NOTNLM
OT  - Breast cancer
OT  - lymph node involvement
OT  - predictive factors
OT  - sentinel node biopsy
EDAT- 2018/06/01 06:00
MHDA- 2018/06/12 06:00
CRDT- 2018/06/01 06:00
PHST- 2018/03/13 00:00 [received]
PHST- 2018/04/29 00:00 [revised]
PHST- 2018/05/03 00:00 [accepted]
PHST- 2018/06/01 06:00 [entrez]
PHST- 2018/06/01 06:00 [pubmed]
PHST- 2018/06/12 06:00 [medline]
AID - 38/6/3657 [pii]
AID - 10.21873/anticanres.12642 [doi]
PST - ppublish
SO  - Anticancer Res. 2018 Jun;38(6):3657-3662. doi: 10.21873/anticanres.12642.