PREDICTIVE FACTORS AFFECTING THE INVOLVEMENT OF NONSENTINAL LYMPH NODES IN BREAST CANCER CASES WITH SENTINAL LYMPH NODES POSITIVE
Project no. 137 · Status: Kapanmış · 2017
Summary
Sentinel lymph node biopsy has become the standard treatment for patients with invasive breast cancer. Intra-operative frozen section allows for the detection of nodal metastases, thereby allowing a simultaneous axillary lymph node dissection for those patients with nodal metastases. However, in many cases although the sentinel lymph node is metastatic, there is no metastasis in non-sentinel axillary dissection. In our study, it was aimed to reveal frozen section findings that will enable the detection of these cases. A total of 770 Sentinel lymph node examinations were performed between January 2016 and December 2018 in our institute. 180 cases with metastasis in the sentinel lymph node and subsequently underwent axillary dissection were included in our study. The specificity of sentinel lymph node examination with frozen section was found to be 79.7%. If lymph nodes containing isolated tumor cells are considered benign, 63 cases (8%) were diagnosed as false negative in the evaluation of sentinel lymph nodes with frozen section, and in 71% of these cases, the metastatic focus size is smaller than 2 mm. Axillary non-sentinel lymph node metastasis was observed in 9% (2/22) of the cases with the largest metastatic focus size in the sentinel lymph node ?4 mm; in 71% (46/65) of the cases with the largest metastatic focus size in the sentinel lymph node >10 mm; in 73% (66/90) of cases with extracapsular extension of the sentinel lymph node metastasis; in 86% (43/50) of the cases with extracapsular extension detected during frozen section; in 84% (42/50) of cases with extracapsular extension size greater than 2 mm and in 74% of the cases (23/31) with metastases in more than two sentinel lymph nodes. In conclusion, detection of extracapsular extension during frozen section is one of the most important findings in showing axillary non-sentinel lymph node involvement. Other findings can be listed as the number of metastatic lymph nodes greater than 2, the largest metastatic focus size greater than 10 mm, and the largest size of extracapsular extension being greater than 2 mm.