TY - JOUR
T1 - The clinical relevance of positive sentinel nodes only versus positive nonsentinel lymph nodes in breast cancer patients
AU - Cox, Charles
AU - DuPont, Elisabeth L.
AU - Furman, Ben
AU - Stowell, Nicholas
AU - Clark, John
AU - Ebert, Mark
AU - Diaz, Nils M.
AU - Cantor, Alan
PY - 2003/10
Y1 - 2003/10
N2 - Background The purpose of this study was to determine the difference in clinical outcomes for patients with histologically positive sentinel lymph nodes (SLN+) compared with patients with histologically positive nonsentinel second echelon lymph nodes (NSLN+). Methods Eight hundred thirteen node positive patients from a prospectively accrued database of 3,200 patients who underwent sentinel node mapping were evaluated. In all, 506 of the 813 patients (62%) were SLN+ only and 307 of the 813 patients (38%) were SLN+ plus at least one NSLN+. Patients' overall survival and disease-free survival were obtained and statistical analyses performed comparing the two groups. Results As the number of NSLN+ increased, there was a significant difference in disease-free survival (P = 0.001) and overall survival (P = 0.003) between those patients who had 0 to 4 NSLN+ and those who had 5 or more NSLN+. The SLN+ only patients did not show significant differences with respect to survival, based on the number of SLN+ (overall survival, disease-free survival; P = 0.742) Conclusions The survival (overall survival, disease-free survival) for patients with 3 or more SLN+ was not statistically different than for patients with 1 or 2 SLN+ (P = 0.742). However, an alteration of biologic behavior was observed when multiple NSLN+ contain metastatic breast cancer. Involvement of 5 or more NSLN+ portends a significantly (P = 0.001) worse prognosis, regardless of the number of SLN+.
AB - Background The purpose of this study was to determine the difference in clinical outcomes for patients with histologically positive sentinel lymph nodes (SLN+) compared with patients with histologically positive nonsentinel second echelon lymph nodes (NSLN+). Methods Eight hundred thirteen node positive patients from a prospectively accrued database of 3,200 patients who underwent sentinel node mapping were evaluated. In all, 506 of the 813 patients (62%) were SLN+ only and 307 of the 813 patients (38%) were SLN+ plus at least one NSLN+. Patients' overall survival and disease-free survival were obtained and statistical analyses performed comparing the two groups. Results As the number of NSLN+ increased, there was a significant difference in disease-free survival (P = 0.001) and overall survival (P = 0.003) between those patients who had 0 to 4 NSLN+ and those who had 5 or more NSLN+. The SLN+ only patients did not show significant differences with respect to survival, based on the number of SLN+ (overall survival, disease-free survival; P = 0.742) Conclusions The survival (overall survival, disease-free survival) for patients with 3 or more SLN+ was not statistically different than for patients with 1 or 2 SLN+ (P = 0.742). However, an alteration of biologic behavior was observed when multiple NSLN+ contain metastatic breast cancer. Involvement of 5 or more NSLN+ portends a significantly (P = 0.001) worse prognosis, regardless of the number of SLN+.
KW - Breast cancer
KW - Lymphatic mapping
KW - Nonsentinel lymph nodes
KW - Outcome
KW - Prognosis
KW - Recurrence
KW - Sentinel lymph nodes
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U2 - 10.1016/S0002-9610(03)00266-6
DO - 10.1016/S0002-9610(03)00266-6
M3 - Article
C2 - 14553845
AN - SCOPUS:0142151075
SN - 0002-9610
VL - 186
SP - 333
EP - 336
JO - American journal of surgery
JF - American journal of surgery
IS - 4
ER -