Factors associated with involvement of four or more axillary nodes for sentinel lymph node-positive patients

Journal Article · Mon May 01 04:00:00 EDT 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2005.1· OSTI ID:20793453

Katz, Angela ^[1]; Niemierko, Andrzej ^[1]; Gage, Irene ^[2]; Evans, Sheila ^[2]; Shaffer, Margaret ^[2]; Smith, Frederick P ^[2]; Taghian, Alphonse ^[1]; Magnant, Colette ^[2]

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1. Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)
2. Breast Cancer Treatment Group, Sibley Memorial Hospital, Washington, DC (United States)

Purpose: Sentinel lymph node-positive (SLN+) patients who are unlikely to have 4 or more involved axillary nodes might be treated with less extensive regional nodal radiation. The purpose of this study was to define possible predictors of having 4 or more involved axillary nodes. Methods and Materials: The records of 224 patients with breast cancer and 1 to 3 involved SLNs, who underwent completion axillary dissection without neoadjuvant chemotherapy or hormonal therapy were reviewed. Factors associated with the presence of 4 or more involved axillary nodes (SLNs plus non-SLNs) were evaluated by Pearson chi-square test of association and by simple and multiple logistic-regression analysis. Results: Of 224 patients, 42 had involvement of 4 or more axillary nodes. On univariate analysis, the presence of 4 or more involved axillary nodes was positively associated with increased tumor size, lobular histology, lymphovascular space invasion (LVSI), increased number of involved SLNs, decreased number of uninvolved SLNs, and increased size of SLN metastasis. On multivariate analysis, the presence of 4 or more involved axillary nodes was associated with LVSI, increased number of involved SLNs, increased size of SLN metastasis, and lobular histology. Conclusions: Patients with 1 or more involved SLN, LVSI, or SLN macrometastasis should be treated to the supraclavicular fossa/axillary apex if they do not undergo completion axillary dissection. Other SLN+ patients might be adequately treated with less extensive radiation fields.

• OSTI ID: 20793453
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 65; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOPSY
CARCINOMAS
CHEMOTHERAPY
HISTOLOGY
LYMPH NODES
MAMMARY GLANDS
METASTASES
PATIENTS
REGRESSION ANALYSIS