Universität zu Köln

Malter, Wolfram, Hellmich, Martin, Badian, Mayhar, Kirn, Verena, Mallmann, Peter and Kraemer, Stefan (2018). Factors Predictive of Sentinel Lymph Node Involvement in Primary Breast Cancer. Anticancer Res., 38 (6). S. 3657 - 3663. ATHENS: INT INST ANTICANCER RESEARCH. ISSN 1791-7530

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Abstract

Background/Aim: Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) for axillary staging in patients with early-stage breast cancer. The need for therapeutic ALND is the subject of ongoing debate especially after the publication of the ACOSOG Z0011 trial. In a retrospective trial with univariate and multivariate analyses, factors predictive of sentinel lymph node involvement should be analyzed in order to define tumor characteristics of breast cancer patients, where SLNB should not be spared to receive important indicators for adjuvant treatment decisions (e.g. thoracic wall irradiation after mastectomy with or without reconstruction). Patients and Methods: Between 2006 and 2010, 1,360 patients with primary breast cancer underwent SLNB withlwithout ALND with evaluation of tumor localization, multicentricity and multifocality, histological subtype, tumor size, grading, lymphovascular invasion (LVI), and estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 status. These characteristics were retrospectively analyzed in univariate and multivariate logistic regression models to define significant predictive factors for sentinel lymph node involvement. The multivariate analysis demonstrated that tumor size and LVI (p<0.001) were independent predictive factors for metastatic sentinel lymph node involvement in patients with early-stage breast cancer. Conclusion: Because of the increased risk for metastatic involvement of axillary sentinel nodes in cases with larger breast cancer or diagnosis of LVI, patients with these breast cancer characteristics should not be spared from SLNB in a clinically node-negative situation in order to avoid falsenegative results with a high potential for wrong indication of primary breast reconstruction or wrong non-indication of necessary post-mastectomy radiation therapy. The prognostic impact of avoidance of axillary staging with SLNB is analyzed in the ongoing prospective INSEMA trial.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Malter, Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Badian, Mayhar UNSPECIFIED UNSPECIFIED UNSPECIFIED Kirn, Verena UNSPECIFIED UNSPECIFIED UNSPECIFIED Mallmann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Kraemer, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-183764
DOI:	10.21873/anticanres.12642
Journal or Publication Title:	Anticancer Res.
Volume:	38
Number:	6
Page Range:	S. 3657 - 3663
Date:	2018
Publisher:	INT INST ANTICANCER RESEARCH
Place of Publication:	ATHENS
ISSN:	1791-7530
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AXILLARY DISSECTION; METASTASES; BIOPSY; WOMEN; CARCINOMA; SURVIVAL; SIZE Multiple languages Oncology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18376