Non-visualized sentinel nodes in breast cancer patients; prevalence, risk factors, and prognosis.

Autor: Verheuvel NC; Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands., Voogd AC; Department of Medical Oncology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands. adri.voogd@maastrichtuniversity.nl.; Department of Epidemiology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. adri.voogd@maastrichtuniversity.nl.; Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands. adri.voogd@maastrichtuniversity.nl., Tjan-Heijnen VCG; Department of Medical Oncology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands., Siesling S; Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.; Department of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands., Roumen RMH; Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands.; Department of Medical Oncology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands.
Jazyk: angličtina
Zdroj: Breast cancer research and treatment [Breast Cancer Res Treat] 2018 Jan; Vol. 167 (1), pp. 147-156. Date of Electronic Publication: 2017 Aug 31.
DOI: 10.1007/s10549-017-4483-2
Abstrakt: Background: Evidence and consensus is lacking in international guidelines regarding axillary treatment recommendations for patients in whom a sentinel lymph node (SLN) cannot be visualized (non-vSLN) during the sentinel node procedure. In this study we aimed to determine the prevalence of non-vSLNs in a Dutch population of breast cancer patients and to examine predictors and survival rate for non-vSLN.
Methods: A nationwide, retrospective, population-based study was performed including 116,920 patients with invasive breast cancer who underwent a SLN procedure in the Netherlands between January 2005 and December 2013.
Results: Of the 76,472 clinically negative patients who underwent a SLN procedure, 1924 patients (2.5%) had a non-vSLN, of whom 1552 (80.7%) underwent an ALND. Multivariate analysis showed predictive factors for non-vSLN: older age (p < 0.001), diagnosis in the period 2005-2009 (p < 0.001), larger tumor size (p = 0.003), and extensive nodal involvement (p < 0.001). Multivariate survival analysis showed a significantly worse survival (HR 1.18, 95% CI 1.03-1.34, p = 0.015) for non-vSLNs patients. However, in the non-vSLN group, an ALND was not statistically significantly associated with a better survival (HR 0.96, 95% CI 0.53-1.75, p = 0.891).
Conclusion: Patients with non-vSLNs had less favorable disease characteristics and a worse survival compared to patients with a visualized SLN. Performing an ALND was not associated with a significantly better survival in patients with non-vSLNs. However, further research on the necessity of axillary treatment in this specific patient group is required.
Databáze: MEDLINE
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