The Relationship Between Positive Sentinel Lymph Node Biopsy and Residual Axillary Lymph Nodes Status in Early Stage Breast Cancer

Author(s): Maher H. Ibraheem, Mona Ali, Amr Hafez, Ghada Mohamed, Rimoun Boutrus, Omnia Talaat, Mohamed Gamil

Introduction: For patients with clinically negative axilla, sentinel lymph node biopsy (SLNB) is the standard method for axillary staging Because the SLBNs are the only positive nodes in approximately 40–70% of patients with pathologically proven positive axillae after completion axillary lymph node dissection (ALND), the treatment of patients with a positive SLBN has been reconsidered and the development of predictive tools that select the patients whom routine ALND could be avoided safely.

Purpose: to characterize the patients in whom completion ALND can be avoided in spite of positive SLNB. Patients and methods: This retrospective study included all patients who had SLNB at the National Cancer Institute, Cairo, Egypt, between January 2013 and December 2015. The characteristics of the special group with positive SLNB and node-negative upon completion ALND were studied.

Results: out of 66 patients with clinically negative axillae, SLNB was negative in 36 patients, with no more ALND, and SLNB was positive in 30 patients for whom completion ALND was done, and revealed that 63.4% (19 out of 30 patients) had no other positive nodes after completion ALND.

Conclusion: In patients with clinically negative axillae and positive sentinel SLNB, A combination of multiple predictive parameters as, the number of positive SLNs, the ratio between metastatic SLNs and total number of SLN retrieved, extracapsular invasion, and lymphovascular invasion were significant predictors for the risk of non- SLN involvement and can identify the patients with positive SLNB for whom routine ALND could be safely avoided.

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