Predictors of Positive Axillary Node Clearance Following Positive Sentinel Node Biopsy: A Retrospective Analysis

TL;DR

This study explores whether features of sentinel node biopsy can predict further axillary cancer spread in breast cancer patients.

Contribution

The study identifies sentinel node deposit size and extracapsular spread as potential predictors of axillary disease.

Findings

Larger sentinel node deposits were associated with positive axillary node clearance (p=0.020).

Deposits under 3 mm predicted no further axillary disease via logistic regression.

Extracapsular spread was also a significant predictor (p=0.042).

Abstract

Background

Axillary management in breast cancer is increasingly de-escalated. This study assessed whether sentinel node biopsy (SNB) histological features predict further axillary disease.

Methods

A retrospective single-centre study was performed of patients with primary breast cancer who underwent axillary node clearance (ANC) following a positive SNB. Sentinel node deposit size and extracapsular spread were analysed using t-tests and chi-square testing. Logistic regression with receiver operating characteristic analysis was used to evaluate deposit size as a predictor of positive ANC.

Results

Forty-two patients were included, of whom 23 (55%) had further nodal metastases. Larger SN deposits were associated with positive ANC (p=0.020). Logistic regression identified deposits <3 mm as predictive of no further axillary disease. Extracapsular spread was also significant (p=0.042).

Conclusions

These findings support selective axillary de-escalation, although validation in larger prospective studies is required.

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