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ORIGINAL ARTICLE
Year : 2014  |  Volume : 4  |  Issue : 2  |  Page : 78-84

The relationship between sentinel lymph node metastasis size, extracapsular extension and survival in breast cancer


1 Department of Surgery, Henry Ford Health System, W Grand Boulevard, Detroit, Michigan, USA
2 Department of Pathology, Henry Ford Health System, W Grand Boulevard, Detroit, Michigan, USA
3 Department of Public Health, Division of Biostatistics and Epidemiology, Henry Ford Health System, W Grand Boulevard, Detroit, Michigan, USA

Correspondence Address:
S David Nathanson
2799 West Grand Boulevard Detroit, Michigan 48202
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-9596.143083

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Background: Sentinel lymph node (SLN) tumor metastasis size (TMS) and extra-capsular extension (ECE) are predictive of non-SLN metastasis. We hypothesized that SLNTMS and ECE would also be predictive of systemic metastasis and death. Materials and Methods: Data from 2,001 women with breast cancer who underwent SLN biopsy were prospectively collected and retrospectively analyzed. SLNTMS and ECE were measured, reported according to standard pathologic protocols and recorded. Data were analyzed from 252 patients with both SLNTMS and ECE information available. Cancer-specific mortality and all-cause mortality were observed, calculated and multivariable analyses performed to identify significant interacting variables amongst demographics, clinical stage and pathological characteristics. Results: Thirty eight treated patients died from any cause and 12 died of cancer during the 16.4 year follow-up. Patients with ER expression had a significantly lower risk of dying of cancer compared to those who lacked ER expression (HR = 0.198, 95% CI 0.06-0.62; P = 0.006). SLNTMS (P = 0.929 and 0.677) and ECE (P = 0.723 and 0.926) were not significant in the multivariable models of either disease specific or all-cause mortality. Conclusion: Neither SLNTMS nor the presence of ECE affected disease-specific or overall mortality in our breast cancer patients.


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