Prognostic implications of positive nonsentinel lymph nodes removed during selective sentinel lymphadenectomy for breast cancer

Breast J. 2009 May-Jun;15(3):242-6. doi: 10.1111/j.1524-4741.2009.00712.x.

Abstract

Nonsentinel lymph nodes (SLNs) are commonly removed at the time of selective sentinel lymphadenectomy (SSL). Their predictive value for the rest of the nodal basin is unknown. A retrospective review of 436 breast cancer patients who underwent SSL between 12/97 and 04/03 at a single institution. One-hundred nineteen patients had non-SLNs removed at SSL; eight were positive (6.7%). Positive non-SLNs predicted that SLNs would also be positive (p = 0.008). There was no difference in rates of additional positive nodes found on completion axillary node dissection between the non-SLN and SLN positive patients (p = 0.62). After adjustment for covariates, the presence of positive non-SLNs was not associated with poorer disease free survival (p = 0.24), time to systemic recurrence (p = 0.57), or overall survival (p = 0.70). Positive non-SLNs removed during SSL are not a significant risk factor for additional positive nodes on completion axillary nodal dissection (CALND) or for worse survival than positive SLNs.

MeSH terms

  • Adult
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery*
  • Female
  • Humans
  • Lymph Node Excision*
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery*
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy / methods*
  • Treatment Outcome