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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2015

01-07-2015 | Breast Oncology

Clinical Significance of Extracapsular Invasion at Sentinel Lymph Nodes in Breast Cancer Patients with Sentinel Lymph Node Involvement

Authors: Hideo Shigematsu, MD, PhD, Kenichi Taguchi, MD, PhD, Hiroko Koui, MD, Shinji Ohno, MD, PhD

Published in: Annals of Surgical Oncology | Issue 7/2015

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Abstract

Background

A certain number of patients have extracapsular invasion (ECI) at the sentinel lymph node (SLN), but only a few reports describe its clinical significance. This study aimed to determine the clinical significance of ECI at SLN in breast cancer patients with involved SLN.

Methods

This study evaluated ECI at SLN in 131 consecutive SLN-positive patients who underwent axillary lymph node dissection between 2003 and 2008 at the National Kyushu Cancer Center with regard to their long-term prognosis and non-SLN metastasis.

Results

Of the 131 patients, 46 (35 %) tested positive for ECI at SLN. Of these 46 patients, 61 % (28/46) had non-SLN metastasis compared with 28 % (24/85) in ECI-negative group (χ 2 test; P < 0.001). Multivariate analysis showed that ECI at SLN is significantly predictive for non-SLN metastasis [hazard ratio (HR) 3.2; 95 % confidence interval (CI) 1.4–7.1; P = 0.005]. The 5-year recurrence-free survival (RFS) rates were 71.3 % in the ECI-positive group and 89.9 %in the ECI-negative group (P = 0.001, log-rank test). Cox-regression analysis showed that ECI at SLN independently predicts lower RFS (HR 4.5; 95 % CI 1.8–11.7; P = 0.002).

Conclusions

The findings show that ECI at SLN is an independent predictor of both non-SLN metastasis and poor prognosis for breast cancer patients with involved SLN. The clinical significance of ECI at SLN in operable-stage breast cancer warrants further study.
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Metadata
Title
Clinical Significance of Extracapsular Invasion at Sentinel Lymph Nodes in Breast Cancer Patients with Sentinel Lymph Node Involvement
Authors
Hideo Shigematsu, MD, PhD
Kenichi Taguchi, MD, PhD
Hiroko Koui, MD
Shinji Ohno, MD, PhD
Publication date
01-07-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 7/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4269-2

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