ABSTRACT
PURPOSE: Axillary lymph node dissection in breast cancer patients with positive sentinel lymph node (SLN) is accepted as a routine procedure. In a significant proportion of women with breast cancer, the SLN is the sole site of regional metastasis. These patients would not be expected to benefit from complete lymph node dissection. The purpose of this study is to determine which factors are associated with additional positive lymph nodes in the axilla of patients who have positive sentinel lymph nodes. METHODS: Between September 2001 and May 2005, we examined 135 cases where the patients underwent a breast conserving operation and a SLN biopsy. There were 34 patients with positive SLN. Univariate analysis was used to identify the clinicopathologic features in the SLN positive patients that can predict metastasis in the nonsentinel lymph nodes (NSLNs). RESULTS: Fifteen patients (44.1%) had metastasis in the NSLNs. There were significant differences in the location of tumors (p=0.018), the nodal status of each patient (p=0.001) and c-erbB2 protein expression (p =0.017) in NSLN metastasis as determined by univariate analysis. CONCLUSION: The location of the breast cancer, nodal status and c-erbB2 expression are of predictive value for NSLN involvement. We suggest that a full axillary lymph node dissection may be considered as a sparing treatment in these situations.