84P Predictive factors for non-sentinel lymph node involvement in patients with breast cancer and 1-2 positive sentinel lymph nodes treated with breast conservation

SummaryThe authors present a procedure guideline for scintigraphic detection of sentinel lymph nodes in malignant melanoma and other skin tumours, in breast cancer, in head and neck cancer, and in prostate and penile carcinoma. Important goals of sentinel lymph node scintigraphy comprise reduction of the extent of surgery, lower postoperative morbidity and optimization of histopathological examination focussing on relevant lymph nodes. Sentinel lymph node scintigraphy itself does not diagnose tumorous lymph node involvement and is not indicated when lymph node metastases have been definitely diagnosed before sentinel lymph node scintigraphy. Procedures are compiled with the aim to reliably localise sentinel lymph nodes with a high detection rate typically in early tumour stages. Radiation exposure is low so that pregnancy is not a contraindication for sentinel lymph node scintigraphy. Even with high volumes of scintigraphic sentinel lymph node procedures surgeons, theatre staff and pathologists receive a radiation exposure < 1 mSv/year so that they do not require occupational radiation surveillance.

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Predictive factors for non-sentinel lymph node involvement in breast cancer patients with a positive sentinel node: should we consider sentinel node-related factors?

Clinical & Translational Oncology ◽

10.1007/s12094-009-0333-y ◽

2009 ◽

Vol 11 (3) ◽

pp. 165-171 ◽

Cited By ~ 12

Author(s):

José Luis Fougo ◽

Mariana Afonso ◽

Francisco Senhorães Senra ◽

Teresa Dias ◽

Conceição Leal ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Sentinel Node ◽

Predictive Factors ◽

Lymph Node Involvement ◽

Positive Sentinel Node ◽

Breast Cancer Patients ◽

Related Factors ◽

Node Involvement

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The Microanatomic Location of Metastatic Breast Cancer in Sentinel Lymph Nodes Predicts Nonsentinel Lymph Node Involvement

Annals of Surgical Oncology ◽

10.1245/s10434-007-9803-z ◽

2008 ◽

Vol 15 (5) ◽

pp. 1309-1315 ◽

Cited By ~ 16

Author(s):

Carolien H. M. van Deurzen ◽

Cees A. Seldenrijk ◽

Ron Koelemij ◽

Richard van Hillegersberg ◽

Monique G. G. Hobbelink ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Metastatic Breast ◽

Lymph Node Involvement ◽

Sentinel Lymph Nodes ◽

Node Involvement ◽

Nonsentinel Lymph Node

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Prediction of additional lymph node involvement in breast cancer patients with positive sentinel lymph nodes

Neoplasma ◽

10.4149/312_150922n497 ◽

2016 ◽

Vol 63 (03) ◽

pp. 427-434 ◽

Cited By ~ 2

Author(s):

K. POHLODEK ◽

S. BOZIKOVA ◽

I. MECIAROVA ◽

V. MUCHA ◽

M. BARTOVA ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Cancer Patients ◽

Lymph Node Involvement ◽

Sentinel Lymph Nodes ◽

Breast Cancer Patients ◽

Node Involvement

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Extent of lymph node involvement in breast cancer patients with sentinel lymph node metastasis.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.199 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 199-199

Author(s):

Takeshi Murata ◽

Maiko Takahashi ◽

Tetsu Hayashida ◽

Shigemichi Hirose ◽

Hiromitsu Jinno ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Nodes ◽

Lymph Node Involvement ◽

Breast Cancer Patients ◽

Level Ii ◽

Positive Slns ◽

Node Involvement ◽

The Mean

199 Background: Axillary lymph node dissection (ALND) is a standard procedure in patients with positive sentinel lymph node (SLN). However, the appropriate level of ALND remains to be elucidated. The aim of this study is to determine the extent of lymph node involvement and predictors to assess non-SLN status in patients with metastatic SLNs. Methods: A prospective database of 235 breast cancer patients with metastases in SLNs who underwent ALND at Keio University Hospital from January 2001 to December 2011 was reviewed. Results: The median age of the patients was 54 years (range 28-86 years) and the mean tumor size was 2.08±0.74 cm. The mean total number of sentinel, level I, and level II lymph nodes removed was 2.72, 18.2, and 2.47, respectively. Other tumor factors include 66.5 % lymphatic invasion positive, 23.7% being nuclear grade 3, 89.4% estrogen receptor positive, and 83.2% progesterone receptor positive. Among 235 patients with SLN involvement, non-SLN metastases were identified in 72 (30.7%) patients and 13 (5.5%) patients had metastases at level II nodes.A univariate analysis showed a significant correlation between non-SLN involvement and number of tumor-involved SLNs. The mean number of tumor-involved SLNs in patients with positive non-SLNs was 1.86 compared with 1.33 in patients with negative non-SLNs (p=0.001). Patients with 2 or more positive SLNs showed a significantly higher rate of non-SLN metastases compared with patients with 1 positive SLNs (47.4% (37/78) vs. 22.3% (35/157), p<0.001).The mean number of tumor-involved SLNs in patients with positive lymph nodes in level II was 2.08 compared with 1.46 in patients with negative lymph nodes in level II (p=0.016). Patients with 2 or more positive SLNs showed a significantly higher rate of metastases at level II nodes compared with patients with 1 positive SLNs (10.3% (8/78) vs. 3.2% (5/157), p=0.0026). Conclusions: Among 235 patients with SLN involvement, the positive rate of non-SLN metastases was 30.7%, whereas that of level II lymph nodes was 5.5%. The number of tumor-involved SLNs was a significant predictor of non-SLN involvement and level II lymph node metastases.

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