The Journal of surgical research.2022，Vol.2718.DOI:10.1016/j.jss.2021.09.039

Sentinel Lymph Node Positive Rate Predicts Non-Sentinel Lymph Node Metastasis in Breast Cancer

Wang, Xuefei Zhang, Guochao Zuo, Zhichao Zhu, Qingli Wu, Shafei Zhou, Yidong Mao, Feng Lin, Yan Shen, Songjie Zhang, Xiaohui Qin, Xue Yan, Cunli Ma, Xiaoying Sun, Qiang Shi, Yue
The Journal of surgical research.2022，Vol.2718.DOI:10.1016/j.jss.2021.09.039
✕
  • NSTL
  • Elsevier

Sentinel Lymph Node Positive Rate Predicts Non-Sentinel Lymph Node Metastasis in Breast Cancer

Wang, Xuefei 1Zhang, Guochao 2Zuo, Zhichao 3Zhu, Qingli 4Wu, Shafei 5Zhou, Yidong 1Mao, Feng 1Lin, Yan 1Shen, Songjie 1Zhang, Xiaohui 1Qin, Xue 6Yan, Cunli 7Ma, Xiaoying 8Sun, Qiang 1Shi, Yue9
扫码查看

作者信息

  • 1. Peking Union Med Coll & Hosp,Chinese Acad Med Sci & Peking Union Med Coll
  • 2. Natl Clin Res Ctr,Chinese Acad Med Sci
  • 3. Radiol Dept,Xiangtan Cent Hosp
  • 4. Peking Union Med Coll Hosp,Chinese Acad Med Sci & Peking Union Med Coll
  • 5. Peking Union Med Coll Hosp,Chinese Acad Med Sci
  • 6. Dept Oncol,Langfang Peoples Hosp
  • 7. Breast Surg Dept,Baoji Maternal & Child Hlth Hosp
  • 8. Breast Surg Dept,Qinghai Prov Peoples Hosp
  • 9. Breast Surg Dept,Shanxi Tradit Chinese Med Hosp
  • 折叠

Abstract

Background: To investigate retrospectively an association between the number of metastatic sentinel lymph nodes (SLNs) per total number of SLNs per patient (i.e., the SLN positive rate, or SLN-PR) and non-SLN metastasis in breast cancer. Methods: A large population (n = 2250) underwent SLN dissection from January 1, 2014 to January 1, 2020; 627 (27.87%) had at least one positive SLN (SLN+). Among these, 283 underwent axillary lymph node (ALN) dissection, and formed the test group. Four external validation groups comprised 43 patients treated in 2019. SLN mappings were examined using methylene blue and indocyanine green. Lymph node ultrasound, SLN-PR, and pathological characteristics were compared between patients with and without non-SLN metastasis. An SLN-PR cutoff value was calculated using receiver operating characteristic (ROC) curves. As- sociations between clinicopathological variables and SLN-PR with non-SLN metastasis were analyzed by multivariate logistic regression model. Results: The median age was 47 years (IQR: 42-56 y). The median number of resected SLNs was 4. Patients with positive non-SLNs (126/283, 44.52%) had a median of 2 positive node. SLN-PR > 0.333 was a risk factor for non-SLN positivity (area under the ROC curve, 0.726); and carried significantly higher risk of non-SLN metastasis (P < 0.001). This was validated in the external group. Conclusions: SLN-PR > 0.333 was associated with greater risk of non-SLN metastasis. This provides a reference to non-SLN metastasis in patients with SLN metastasis, an indication for ALN dissection and choice of adjuvant treatment. (C) 2021 Published by Elsevier Inc.

Key words

Breast cancer/Axillary lymph node/Sentinel lymph node/BIOPSY/ONCOLOGY/WOMEN/TRIAL/RADIOTHERAPY/DISSECTION/MORBIDITY/DISEASE/AXILLA/AMAROS

引用本文复制引用

出版年

2022
The Journal of surgical research.

The Journal of surgical research.

ISSN：0022-4804
参考文献量28
段落导航相关论文