Skip to main content
padlock icon - secure page this page is secure

Prediction of tumour involvement in remaining axillary lymph nodes when the sentinel node in a woman with breast cancer contains metastases

The full text article is not available for purchase.

The publisher only permits individual articles to be downloaded by subscribers.


In a significant proportion of women with breast cancer, the sentinel node is the only involved node in the axilla. The purpose of this study was to identify factors associated with histologically positive non‐sentinel lymph nodes.


Between 1997 and 2002, 800 women with early breast cancer underwent sentinel node biopsy. In 263 patients the node contained metastases, including 83 with micrometastases detected by immunohistochemistry (IHC), 40 micrometastases detected on haematoxylin, eosin and safranine (HES) staining, and 140 macrometastases. All clinical and histological criteria were recorded and analysed with reference to histology of the non‐sentinel node.


The risk of metastasis in the non‐sentinel lymph node was related to the volume of the tumour in the sentinel node. Non‐sentinel nodes were involved in five (6·0 per cent) of 83 women when the sentinel node contained only micrometastatic cells detected on IHC, and in three (7·5 per cent) of 40 women when micrometastases were detected by HES, compared with 55 (39·3 per cent) of 140 when the sentinel node contained macrometastases on HES staining. Univariate analysis revealed a significant association between non‐sentinel node involvement and type of metastasis within the sentinel node, clinical primary tumour size, palpable axillary lymph nodes before operation, pathological primary tumour size and the presence of peritumoral lymphovascular invasion. On multivariate analysis, the type of metastasis within the sentinel node (P < 0·001), histological tumour size greater than 20 mm (P = 0·017) and the presence of palpable axillary nodes before operation (P = 0·014) remained significant.


Clinical and pathological factors associated with sentinel node histology can reliably predict women for whom further axillary clearance is recommended, but it is not yet possible to determine a subgroup of patients in whom the sentinel node is the only involved node and for whom further axillary treatment may be unnecessary. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
No References
No Citations
No Supplementary Data
No Article Media
No Metrics

Document Type: Research Article

Affiliations: 1: Department of Surgery, Institut Curie, Paris, France 2: Department of Pathology, Institut Curie, Paris, France 3: Department of Biostatistics, Institut Curie, Paris, France

Publication date: November 1, 2003

More about this publication?
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more