Lymph Node Findings Following Axillary Lymph Node Dissection in Cases of a Positive Sentinel Lymph Node in Breast...

Area of Science:

• Oncology
• Surgical Pathology

Background:

• Axillary lymph node management in breast cancer has evolved, with sentinel lymph node biopsy (SLNB) largely replacing axillary lymph node dissection (ALND) for staging node-negative patients.
• The necessity of completion ALND after a positive SLNB remains under investigation, especially with evidence supporting less aggressive approaches.

Purpose of the Study:

• To determine the frequency and extent of non-sentinel axillary lymph node involvement after a positive SLNB.
• To explore clinicopathological factors associated with additional nodal burden in breast cancer patients.

Main Methods:

• A retrospective, single-center study analyzed 102 female breast cancer patients with positive SLNs between 2018-2019.
• Data on patient and tumor characteristics were collected, including age, surgery type, TNM stage, histology, grade, and molecular subtype.
• Statistical analysis was performed to identify associations with additional nodal disease.

Main Results:

• 58.8% of patients with a positive SLN had additional metastases in non-sentinel axillary lymph nodes after completion ALND.
• 41.2% of patients had no further axillary nodal disease.
• Patients with invasive carcinoma showed a significantly higher nodal burden (p < 0.05).

Conclusions:

• A significant proportion of breast cancer patients with a positive SLNB still have additional axillary metastases, indicating residual nodal disease is common.
• The findings support the ongoing debate regarding de-escalation of axillary surgery in carefully selected breast cancer patients.