Axillary lymph node (ALN) status is an important prognostic factor for breast cancer patients. With increasing numbers of patients undergoing neoadjuvant chemotherapy (NAC), issues concerning sentinel lymph node biopsy (SLNB) after NAC have emerged. We analyzed clinicopathological features and developed a nomogram to predict the possibility of nonsentinel lymph node (NSLN) metastases in patients with positive SLNs after NAC.
A retrospective chart review was performed for 141 patients who were clinically ALN positive at presentation, had a positive SLN after NAC on subsequent SLNB, and underwent axillary lymph node dissection (ALND) between 2008 and 2014.
On univariate analysis, SLN metastasis size, clinical ALN status after NAC, lymphovascular invasion (LVI), number of positive SLNs, number of negative SLNs, and pathologic T stage were significantly associated with likelihood of NSLN metastases (P
The NAC nomogram was developed to predict the likelihood of additional positive NSLNs because this information may help dictate appropriate axillary surgery in the future as we strive to safely minimize axillary morbidity.
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This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea. (HI14C3418)
All authors have declared no conflicts of interest.