The American surgeon
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The American surgeon · Feb 2004
Multicenter StudyNonsentinel lymph node status after positive sentinel lymph node biopsy in early breast cancer.
Axillary dissection is the current standard of care for patients with breast cancer who are diagnosed with metastasis to axillary sentinel lymph nodes (SLNs). Recently, that concept has come under increasing scrutiny because not all women with a positive SLN will need further dissection. The purpose of this study was to look at nonsentinel lymph node status in patients with breast cancer and axillary SLN metastasis in an effort to determine tumor variables that can guide further treatment if there are additional axillary nodes involved. ⋯ The presence of palpable breast mass (P = 0.03), tumor size (P = 0.04), angiolymphatic invasion (P = 0.03), and extracapsular extension of SLN metastasis (P = 0.001) were the variables that predicted non-SLN involvement. Micrometastasis was inversely related to non-SLN involvement. In patients with breast cancer and SLN metastasis, the presence of a palpable breast mass, tumor size, angiolymphatic invasion, and extracapsular node extension increase the likelihood of identifying additional node metastasis on subsequent axillary dissection.