Tumor Characteristics Influencing Non-Sentinel Lymph Node Involvement in Clinically Node Negative Patients with Breast Cancer

Gurleyik, Gunay; Aker, Fügen; Aktekin, Ali; Sağlam, Abdullah

doi:10.4048/jbc.2011.14.2.124

Cited by 11 publications

(8 citation statements)

References 28 publications

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“…The univariate analysis performed in this study illustrated that the HR status, HER2 status, Ki67 level, clinical node stage, clinical T stage, breast pCR, and the number of sentinel metastases were associated with nonsentinel metastasis, consistent with earlier clinical studies 5,20,21 . Lymphovascular invasion was associated with NSLN metastasis, consistent with most other studies 22,23 . In addition, some studies have shown that the molecular subtype classification of BC is a powerful predictor of NSLN metastasis and that some subtypes are more likely to have NSLN metastases than others; however, no similar conclusions have been reached here 30,31 .…”

Section: Discussionsupporting

confidence: 87%

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A nomogram to predict non–sentinel lymph node metastasis in patients with initial cN+ breast cancer that downstages to cN0 after neoadjuvant chemotherapy

Cheng

Zhuang

Zhang

et al. 2020

Journal of Surgical Oncology

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Background and Objectives This study mainly explored the factors that influence non–sentinel lymph node (NSLN) metastasis in patients with breast cancer (BC) whose axillary lymph nodal status changed from clinically node positive (cN+) to clinically node negative (cN0) after neoadjuvant chemotherapy (NAC). Methods We retrospectively analyzed the clinicopathological factors affecting NSLN metastasis in a total of 179 patients with cN+ BC downstaged to cN0 (120 in the training set and 59 in the validation set) who underwent both sentinel lymph node (SLN) biopsy and axillary lymph node dissection following NAC. Results Among 179 patients enrolled, the overall NSLN metastatic rate was 24.0% (95% confidence interval [CI]: 17.7%‐30.3%). In multivariate logistic regression analysis, the number of positive SLNs achieving a pathological complete remission of the breast and clinical node staging was independent predictors of NSLN metastasis. A nomogram was established based on these factors and displayed a good discriminatory capability, with an area under the curve of 0.919 (95% CI: 0.865‐0.973) for the training set and 0.900 (95% CI: 0.812‐0.988) for the validation set and its clinical utility was confirmed by the decision curve analysis. Conclusions The nomogram established showed the ability to predict NSLN metastases in patients with initial cN+ BC that downstaged to cN0 after NAC.

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Section: Discussionsupporting

confidence: 87%

“…In this study, the axillary lymph node‐negative rate after NAC was 50.8%. Previous reports on axillary lymph node‐positive patients showed a conversion rate of axillary nodal status after NAC of 40% to 75% 20‐23 . Thus, a considerable number of patients can theoretically avoid ALND.…”

Section: Discussionmentioning

confidence: 96%

A nomogram to predict non–sentinel lymph node metastasis in patients with initial cN+ breast cancer that downstages to cN0 after neoadjuvant chemotherapy

Cheng

Zhuang

Zhang

et al. 2020

Journal of Surgical Oncology

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“…Axillary metastasis was significantly associated with LVI (p<0.001). 9 Nomogram score were assigned to all patients based on criteria specified in Memorial Sloan Kettering Cancer nomogram.…”

Section: Review Of Literature Factors Affecting Involvement Of Axillamentioning

confidence: 99%

Changing Trends in Axillary Management of Early Breast Cancer: From Radical to Conservative

Sood¹,

Singh²,

Sharma³

2016

IJMRP

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Background:In the last decade, surgical management of breast cancer has evolved from more extensive procedures like radical mastectomy to less invasive breast conserving surgery. Increasing evidence suggests that surgical removal of the axillary lymph nodes (ALN) in early breast cancer yields no advantage in terms of either overall or disease free survival. Significance of sentinel lymph node biopsy (SLNB) in neoadjuvant chemotherapy (NACT) is currently under discussion. A risk of non -sentinel lymph node ( non-SLN) involvement is always present despite negative SLN biopsy . There are various tumour characteristics and patients' factors that are associated with increased risk of non-SLN involvement. Methods: A literature search was performed in the PubMed Database for relevant articles on the role of axillary dissection in node positive early breast cancer, the role of SLNB, SLNB after NACT and the factors affecting involvement of axillary lymph nodes Results: The available literature increasingly cast doubt on the putative therapeutic benefit of axillary lymph node dissection (ALND) as a part of routine multimodal treatment strategy for breast cancer. Various clinicopathological features like lymphovascular invasion (LVI), tumour size, ER, PR, HER-2 status are associated with increased incidence of non -SLN involvement so ALND should be limited to patients with these characteristics inspite of negative SLNB. Conclusion: Current evidence indicates that the radicality of lymph node surgery in the treatment of breast cancer can be reduced, even if the node status is positive.LVI, increased tumour size , Infiltrating ductal carcinoma(IDC), Grade II&III and ER , PR, HER-2 overexpression significantly associated with positive axillary status .

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“…One of the most suitable factors notably evaluated by the researchers is lymphovascular invasion. Up to now, a great number of studies have been conducted in order to find the prognostic role of lymphovascular invasion in breast cancer, especially in 5768 node negative patients (Sebastian et al, 2004;Pauline et al, 2005;Gurleyik et al, 2011). It seems that this factor may be an adverse prognostic factor for survival in patients with breast cancer, especially those with the node negative disease.…”

Section: Vascular Invasion As An Independent Prognostic Factor In Lymmentioning

confidence: 99%

Vascular Invasion as an Independent Prognostic Factor in Lymph Node Negative Invasive Breast Cancer

Rezaianzadeh¹,

Talei²,

Rajaeefard³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Introduction: Identification of simple and measurable prognostic factors is an important issue in treatment evaluation of breast cancer. The present study was conducted to evaluate the prognostic role of vascular invasion in lymph node negative breast cancer patients. Methods: in a retrospective design, we analyzed the recorded profiles of the 1,640 patients treated in the breast cancer department of Motahari clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, from January 1999 to December 2012. Overall and adjusted survivals were evaluated by the Cox proportional hazard model. All the hypotheses were considered two-sided and a p-value of 0.05 or less was considered as statistically significant. Results: Mean age in lymph node negative and positive patients was 50.0 and 49.8 respectively. In lymph node negative patients, the number of nodes, tumor size, lymphatic invasion, vascular invasion, progesterone receptor, and nuclear grade were significant predictors. In lymph node and lymphatic negative patients, vascular invasion also played a significant prognostic role in the survival which was not evident in lymph node negative patients with lymphatic invasion. Discussion: The results of our large cohort study, with long term follow up and using multivariate Cox proportional model and comparative design showed a significant prognostic role of vascular invasion in early breast cancer patients. Vascular invasion as an independent prognostic factor in lymph node negative invasive breast cancer

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Tumor Characteristics Influencing Non-Sentinel Lymph Node Involvement in Clinically Node Negative Patients with Breast Cancer

Cited by 11 publications

References 28 publications

A nomogram to predict non–sentinel lymph node metastasis in patients with initial cN+ breast cancer that downstages to cN0 after neoadjuvant chemotherapy

A nomogram to predict non–sentinel lymph node metastasis in patients with initial cN+ breast cancer that downstages to cN0 after neoadjuvant chemotherapy

Changing Trends in Axillary Management of Early Breast Cancer: From Radical to Conservative

Vascular Invasion as an Independent Prognostic Factor in Lymph Node Negative Invasive Breast Cancer

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