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Residual lymph node tumour burden following removal of a single axillary sentinel lymph with macrometastatic disease in women with screen-detected invasive breast cancer
- Source :
- BJS Open
- Publication Year :
- 2020
-
Abstract
- Background Women with screen-detected invasive breast cancer who have macrometastatic disease on axillary sentinel lymph node biopsy (SLNB) are usually offered either surgical axillary node clearance (ANC) or axillary radiotherapy. These treatments can lead to significant complications for patients. The aim of this study was to identify a group of patients who may not require completion ANC. Methods Data from the NHS Breast Screening Programme between 1 April 2012 and 31 March 2017 were interrogated to identify women with invasive breast carcinoma and a single sentinel lymph node (SLN) with macrometastatic disease who subsequently proceeded to completion ANC. Univariable and multivariable analyses were performed to identify patients with a single positive SLN who had no further lymph node metastasis on ANC. Results Of the 2401 women included in the cohort, the presence of non-sentinel node disease was significantly affected by: the number of nodes obtained at SLNB (odds ratio (OR) 0.49 for retrieval of more than 1 node), invasive size of tumour (OR 1.63 for size greater than 20 mm), surgical treatment (OR 1.34 for mastectomy), human epidermal growth factor receptor (HER) 2 status (OR 0.71 for HER2 positivity), and patient age (OR 1.10 for age less than 50 years; OR 1.46 for age greater than 70 years). Patients aged less than 70 years, with tumour size smaller than 2 cm, more than one node retrieved on SLNB, and who had breast-conserving surgery had a lower chance of positive non-sentinel nodes on completion ANC compared with other patients. Conclusion This study, of a purely screen-detected breast cancer cohort, identified a subset of patients who may be spared completion ANC in the event of a single axillary SLN with macrometastasis.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Sentinel lymph node
Breast Neoplasms
030230 surgery
Mastectomy, Segmental
Metastasis
03 medical and health sciences
0302 clinical medicine
Breast cancer
medicine
Breast-conserving surgery
Humans
Mass Screening
Neoplasm Invasiveness
Lymph node
Early Detection of Cancer
Mastectomy
Aged
business.industry
Sentinel Lymph Node Biopsy
General Medicine
Nomogram
Middle Aged
medicine.disease
Tumor Burden
Axilla
medicine.anatomical_structure
030220 oncology & carcinogenesis
Lymphatic Metastasis
Lymph Node Excision
Female
Original Article
Radiology
business
Mammography
Subjects
Details
- ISSN :
- 24749842
- Volume :
- 5
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- BJS open
- Accession number :
- edsair.doi.dedup.....946b323bc4db2a407928a9803b3219d2