PREDICTIVE FACTORS FOR NON-SENTINEL LYMPH NODE INVOLVEMENT IN PATIENTS WITH BREAST CANCER
DOI:
https://doi.org/10.32461/2226-3209.3.2018.179824Анотація
Abstract. Introduction: Sentinel lymph node biopsy (SLNB) is accepted as a substitute method for axillary staging instead of axially lymph node dissection in patients with negative lymph node. The NSLN involvement is correlated with primary tumor and SLN characteristics. So, the diagnosis of the patients with lower risk of NSLN metastasis will save them from axillary lymph node dissection (ALND)-related morbidities. This study aimed to determine the predictive factors for NSLN involvement in breast cancer patients with positive SLN. Materials and Methods: This cross-sectional study was performed on 482 patients with breast cancer and SLN involvement, referring to Rasoul Akram and Khatam-al-Anbia
Hospital hospitals, Tehran, Iran, during 2010-2017. 6 hours up to one day before the surgery, the patients received a periareolar injection of radioactive materials. Then, all hot lymph nodes with suspected cancer invasion were resected. The SLN radionuclide-avid were subjected to frozen section analysis. Axillary dissection was performed if metastases or even micrometastases were reported in nodes. Results: Overall, 66.5% and 33.5% of the patients had positive and negative SLNs, respectively. The results showed a significant relationship between lymph node involvement in the patients with
breast cancer and SLN in term of non-SLN invasion (χ2=4.62; P<0.005). There was also a significant relationship with lymphovascular invasion (LVI) (χ2=107.4; P<0.005), perineural involvement (χ2=32.27; P<0.005), and extra capsular lymph node involvement (χ2=48.01; P<0.005). 59.3% of the patients with negative HER2-enriched (16 out of 27 cases) had lymphovascular involvement. there was no significant relationship between positive/negative Ki67 with gender and age (P>0.005). Conclusion: As the findings indicated, the patients with involved lymph node, a tumor size of > 2 cm, and high
tumor stage have a significantly higher probability of metastasis progression to NSLN; therefore, they are suggested to undergo ALND.
Keywords: SLNB; Axillary dissection; Non-sentinel
Посилання
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