J Breast Cancer.  2014 Dec;17(4):370-375. 10.4048/jbc.2014.17.4.370.

Subtype Is a Predictive Factor of Nonsentinel Lymph Node Involvement in Sentinel Node-Positive Breast Cancer Patients

• Gulben K
• Berberoglu U
• Aydogan O
• Kinas V

• KMID: 2176129
• DOI: http://doi.org/10.4048/jbc.2014.17.4.370

Abstract

PURPOSE
This study aimed to identify the effect of breast cancer subtype on nonsentinel lymph node (NSLN) metastasis in patients with a positive sentinel lymph node (SLN).
METHODS
The records of 104 early breast cancer patients with a positive SLN between April 2009 and September 2013 were retrospectively evaluated. All patients underwent axillary lymph node dissection. The effects of the tumor subtype (luminal A, luminal/HER2+, human epidermal growth factor receptor 2 [HER2] overexpression, and triple-negative) and other clinicopathological factors on NSLN metastasis were examined by univariate and multivariate statistical analyses.
RESULTS
Fifty of 104 patients (48%) exhibited NSLN metastasis. Univariate and multivariate analyses revealed that tumor size and the ratio of positive SLNs were significant risk factors of NSLN metastasis in patients with a positive SLN. The rate of NSLN metastasis was higher in patients with luminal/HER2+ and HER2 overexpression subtypes than that in patients with other subtypes in the univariate analysis (p<0.001). In the multivariate analysis, both patients with luminal/HER2+ (p<0.006) and patients with HER2 overexpression (p<0.031) subtypes had a higher risk of NSLN metastasis than patients with the luminal A subtype.
CONCLUSION
Subtype classification should be considered as an independent factor when evaluating the risk of NSLN metastasis in patients with a positive SLN. This result supports the development of new nomograms including breast cancer subtype to increase predictive accuracy.

Keyword

Breast neoplasms; Molecular subtypes; Predictive value of tests; Sentinel lymph node biopsy

MeSH Terms

Breast Neoplasms*
Classification
Humans
Lymph Node Excision
Lymph Nodes*
Multivariate Analysis
Neoplasm Metastasis
Nomograms
Phenobarbital
Predictive Value of Tests
Receptor, Epidermal Growth Factor
Retrospective Studies
Risk Factors
Sentinel Lymph Node Biopsy
Phenobarbital
Receptor, Epidermal Growth Factor

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