Predicting Nonsentinel Lymph Node Metastasis in Breast Cancer: A Multicenter Retrospective Study

Area of Science:

• Oncology
• Surgical Pathology
• Breast Cancer Research

Background:

• Sentinel lymph node (SLN) biopsy is standard for node-negative breast cancer.
• Axillary lymph node dissection (ALND) is often performed after SLN metastasis, but non-SLNs frequently lack cancer.
• Predictive factors for non-SLN metastasis require further investigation.

Purpose of the Study:

• To identify predictive factors for metastasis in non-SLNs in breast cancer patients.
• To evaluate the role of Ki67 index and lymph node counts in predicting non-SLN metastasis.
• To determine optimal cutoffs for predictive factors.

Main Methods:

• Retrospective study of 150 operable invasive breast cancer patients with cT1-3, cN0.
• Patients underwent SLN biopsy followed by ALND due to SLN metastasis.
• Clinicopathologic factors, Ki67 index, and SLN counts were analyzed using ROC curves.

Main Results:

• 35% of patients had non-SLN metastasis.
• Optimal cutoffs identified: Ki67 index 12%, ≥2 positive SLNs, ≤1 negative SLN.
• Higher Ki67 and positive SLN counts, and lower negative SLN counts were associated with non-SLN metastasis.

Conclusions:

• The number of negative SLNs is a significant predictor of non-SLN metastasis.
• Consideration of both positive and negative SLN counts is vital for ALND decisions.
• This finding aids in personalized treatment strategies for breast cancer patients.