# 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.

## Key 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.