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Risk Factors for a False-Negative Result of Sentinel Node Biopsy in Patients with Clinically Node-Negative Breast Cancer

Authors
 Seung Ah Lee  ;  Hak Min Lee  ;  Hak Woo Lee  ;  Ban Seok Yang  ;  Jong Tae Park  ;  Sung Gwe Ahn  ;  Joon Jeong  ;  Seung Il Kim 
Citation
 Cancer Research and Treatment, Vol.50(3) : 625-633, 2018 
Journal Title
 Cancer Research and Treatment 
ISSN
 1598-2998 
Issue Date
2018
Keywords
Breast neoplasms ; Prognosis ; Sentinel lymph node ; False negative
Abstract
Purpose: Although sentinel lymph node biopsy (SLNB) can accurately represent the axillary lymph node (ALN) status, the false-negative rate (FNR) of SLNB is the main concern in the patients who receive SLNB alone instead of ALN dissection (ALND). Materials and Methods: We analyzed 1,886 patientswho underwent ALND after negative results of SLNB,retrospectively. A logistic regression analysis was used to identify risk factors associated with a falsenegative (FN) result. Cox regression model was used to estimate the hazard ratio of factors affecting disease-free survival (DFS). Results: Tumor located in the upper outer portion of the breast, lymphovascular invasion, suspicious node in imaging assessment and less than three sentinel lymph nodes (SLNs) were significant independent risk factors for FN in SLNB conferring an adjusted odds ratio of 2.10 (95% confidence interval [CI], 1.30 to 3.39), 2.69 (95% CI, 1.47 to 4.91), 2.59 (95% CI, 1.62 to 4.14), and 2.39 (95% CI, 1.45 to 3.95), respectively. The prognostic factors affecting DFS were tumor size larger than 2 cm (hazard ratio [HR], 1.86; 95% CI, 1.17 to 2.96) and FN of SLNB (HR, 2.51; 95% CI, 1.42 to 4.42) in SLN-negative group (FN and true-negative), but in ALN-positive group (FN and true-positive), FN of SLNB (HR, 0.64; 95% CI, 0.33 to 1.25) did not affect DFS. Conclusion: In patients with risk factors for a FN such as suspicious node in imaging assessment, upper outer breast cancer, less than three harvested nodes, we need attention to find another metastatic focus in non-SLNs during the operation. It may contribute to provide an exact prognosis and optimizing adjuvant treatments.
Files in This Item:
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DOI
10.4143/crt.2017.089
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김승일(Kim, Seung Il)
박종태(Park, Jong Tae)
안성귀(Ahn, Sung Gwe) ORCID logo https://orcid.org/0000-0002-8778-9686
양반석(Yang, Ban Seok)
이학우(Lee, Hak Woo)
정준(Jeong, Joon) ORCID logo https://orcid.org/0000-0003-0397-0005
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162679
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