Positive predictors of sentinel Lymphnode positivity

Abstract

INTRODUCTION: Lymph node status is the single most important prognostic and predictive factor in breast cancer. Therefore, place of proper axillary staging is invaluable and it was routine to perform an axillary Lymph node dissection. Currently, Sentinel Lymph node Biopsy (SLNB) is an oncologically accepted technique for axillary staging in clinically negative axillae with less morbidity. Positive predictors for a histologically positive sentinel lymph node (SLN) are multifactorial. MATERIAL AND METHODS: We did a prospective analytical study since January 2013 in a single unit in patients with early breast cancer and clinically negative axillae. They were offered mastectomy or breast conservation with SLNB. We used Isolated Methylene Blue technique for SLNB. All data regarding pre-op evaluation, surgical data and histological details are recorded in a database. Pearson's chisquare test, Fishers exact test and logistic regression statistical tools were used. P < 0.05 was considered as significant. RESULTS: Total number of patients included were 253 and 48 (18.97%) had histologically Positive SLN. Median SLN harvest was 3. Predictors SLN positivity: on univariate analysis Pathological SLN size, Clinical T stage (T2 vs <T2), Tumor location (Subareolar and Upper Outer quadrant), Histological grade of tumor, Vascular emboli showed statistically significant correlation. But receptor status and age were not significant factors. Multiple logistic regression analysis showed only the tumor location was significant. CONCLUSIONS: Pathological SLN size, Clinical T stage, Tumor location, Histological grade of tumor and presence of Vascular emboli are the positive predictors of histologically positive SLNB in our study.