Predicting non-Sentinel lymph node status in Sentinel Node-Positive Breast Cancer Patients

Backgrounds: Axillary lymph node dissection (ALND) has traditionally been the recommended treatment for a positive sentinel node. However, almost 50 % of sentinel lymph node positive patients have negative non-sentinel nodes and undergo non-therapeutic axillary dissection. Omitting ALND in this group, results in declining morbidity associated to axillary dissection. The aim of this study is to evaluate the factors which may help predicting non-sentinel lymph node status in sentinel node-positive patients. Methods: From January 1999 to November 2015, 356 patients with SLNpositive breast cancer at Breast Diseases Research Center (Shiraz University of Medical Sciences), who had undergone ALND, were enrolled in this retrospective study. Two groups (ALND-positive and ALNDNegative) were compared in terms of demographic, histopathologic and molecular characters. Results: Multivariate analysis demonstrated that only the lymphovascular invasion was associated with non-sentinel nodes metastases (p < 0.001). Our findings do not support association between T size or ER and non-sentinel nodes metastases. Conclusion: Lymphovascular invasion is a strong predictor for non-sentinel nodal status. However further single and multi centric studies may need to assess other predicting factors.