Sentinel lymph node biopsy in breast cancer: predictors of axillary and non-sentinel lymph node involvement.

Background: Sentinel lymph node biopsy is a standard method for the evaluation of axillary status in patients with T1-2N0M0 breast cancers. Aims: To determine the prognostic significance of primary tumour-related clinico-histopathological factors on axillary and non-sentinel lymph node involvement of patients who underwent sentinel lymph node biopsy. Study design: Retrospective clinical study. Methods: In the present study, 157 sentinel lymph node biopsies were performed in 151 consecutive patients with early stage breast cancer between June 2008 and December 2011. Results: Successful lymphatic mapping was obtained in 157 of 158 procedures (99.4%). The incidence of larger tumour size (2.543aplusmn;1.21 vs. 1.974aplusmn;1.04), lymphatic vessel invasion (70.6% vs. 29.4%), blood vessel invasion (84.2% vs. 15.8%), and invasive lobular carcinoma subtype (72.7% vs. 27.3%) were statistically significantly higher in patients with positive SLNs. Logistic stepwise regression analysis disclosed tumour size (odds ratio: 1.51, p=0.0021) and lymphatic vessel invasion (odds ratio: 4.68, p=0.001) as significant primary tumour-related prognostic determinants of SLN metastasis. Conclusion: A close relationship was identified between tumour size and lymphatic vessel invasion of the primary tumour and axillary lymph node involvement. However, the positive predictive value of these two independent variables is low and there is no compelling evidence to recommend their use in routine clinical practice. Turkish Baslik:Meme Kanserinde Bekci Lenf Nodu Biyopsisi; Aksiller ve Bekci Disi Lenf Nodu Tutulumunun Belirleyicileri Anahtar Kelimeler:Meme neoplazmlari, lenfatik metastaz, bekci lenf nodu biyopsisi Arkaplan: Bekci lenf nodu biopsisi (BLNB), T1-2N0M0 meme kanserli hastalarda aksilla durumunun degerlendirmesi icin standart bir yontemdir. Amac: BLNB yapilan hastalarda, aksiller ve bekci disi lenf nodu tutulumu uzerinde birincil tumor ile ilgili klinik-histopatolojik faktorlerin prognostik onemini belirlemektir. Calisma Tasarimi: Geriye donuk (retrospektif) klinik calisma Yontemler: Bu calismada, Haziran 2008 ve Aralik 2011 tarihleri arasinda erken evre meme kanseri olan ardisik 151 hastaya 157 BLNB uygulandi. Bulgular: Yuz elli sekiz prosedurun 157a#39;sinde basarili lenfatik haritalama elde edildi. BLN tutulumu olan hastalarda buyuk tumor boyutu (2.543aplusmn;1.21a#39;e karsi 1.974aplusmn;1.04), lenf damar invazyonu (LDI) (%70.6a#39;e karsi %29.4), kan damar invazyonu (KDI) (%84.2a#39;e karsi %15.8) ve invaziv lobuler karsinom alt tipi (%72.7a#39;e karsi %27.3) istatistiksel olarak anlamli derecede yuksek bulundu. Lojistik asamali regresyon analizinde, birincil tumor ile ilgilibu dort prognostik belirleyicilerden LDI (Odds Ratio: 4.68, p=0.001) ve tumor boyutu (Odds Ratio: 1.51, p=0.0021) BLN metastazi uzerinde en belirgin etkiye sahipti. Sonuc: Tumor boyutu ve birincil tumorun lenf damar invazyonu ile aksiller lenf nodu tutulumu arasinda yakin bir iliski tespit edilmistir. Ancak bu iki bagimsiz degiskenin pozitif ongoru degeri dusuk olup rutin klinik uygulamada kullanimini onermek icin hicbir zorlayici kanit mevcut degildir.