Tumour-Positive Axillary Sentinel Nodes and Their Association with Non-sentinel Node Involvement in Subsequent Axillary Clearance in Breast Cancer

Abstract

Introduction: This study is based on our observation that more than half of the breast cancer patients with only one tumourpositive axillary sentinel node are found to have regional disease limited to the sentinel node after completion of axillary clearance. These patients are exposed to the morbidity of axillary clearance with no tangible additional therapeutic benefit.Methods: Axillary clearance was performed in all tumour-positive sentinel node patients.Results: Out of 38 consecutive patients with tumour-positive sentinel nodes, 23 patients had one tumour-positive sentinel lymph node involved and the other 15 patients had more than one tumour-positive sentinel lymph nodes; 13.04% of single tumour-positive sentinel node patients (Group1) and 33.3% of more than one tumour-positive sentinel node patients (Group2) had metastasis to the non-sentinel nodes. Conclusions: More than one tumour-positive sentinel nodes patients are 2.56 times more likely to have positive nonsentinel lymph nodes than patients with only one tumour-positive sentinel node. As this association is not statistically significant, the current practice of axillary dissection following positive sentinel nodes should be continued.