Risk factors for a false-negative result of sentinel node biopsy in patients with clinically node-negative breast cancer

Seung Ah Lee, Hak Min Lee, Hak Woo Lee, Ban Seok Yang, Jong Tae Park, Sung Gwe Ahn, Joon Jeong, Seung Il Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 patients who 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.

Original languageEnglish
Pages (from-to)625-633
Number of pages9
JournalCancer Research and Treatment
Volume50
Issue number3
DOIs
Publication statusPublished - 2018 Jul 1

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Sentinel Lymph Node Biopsy
Confidence Intervals
Breast Neoplasms
Biopsy
Disease-Free Survival
Lymph Nodes
cyhalothrin
Lymph Node Excision
Proportional Hazards Models
Dissection
Neoplasms
Breast
Logistic Models
Odds Ratio
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Lee, Seung Ah ; Lee, Hak Min ; Lee, Hak Woo ; Yang, Ban Seok ; Park, Jong Tae ; Ahn, Sung Gwe ; Jeong, Joon ; Kim, Seung Il. / Risk factors for a false-negative result of sentinel node biopsy in patients with clinically node-negative breast cancer. In: Cancer Research and Treatment. 2018 ; Vol. 50, No. 3. pp. 625-633.
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title = "Risk factors for a false-negative result of sentinel node biopsy in patients with clinically node-negative breast cancer",
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 patients who 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.",
author = "Lee, {Seung Ah} and Lee, {Hak Min} and Lee, {Hak Woo} and Yang, {Ban Seok} and Park, {Jong Tae} and Ahn, {Sung Gwe} and Joon Jeong and Kim, {Seung Il}",
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Risk factors for a false-negative result of sentinel node biopsy in patients with clinically node-negative breast cancer. / Lee, Seung Ah; Lee, Hak Min; Lee, Hak Woo; Yang, Ban Seok; Park, Jong Tae; Ahn, Sung Gwe; Jeong, Joon; Kim, Seung Il.

In: Cancer Research and Treatment, Vol. 50, No. 3, 01.07.2018, p. 625-633.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors for a false-negative result of sentinel node biopsy in patients with clinically node-negative breast cancer

AU - Lee, Seung Ah

AU - Lee, Hak Min

AU - Lee, Hak Woo

AU - Yang, Ban Seok

AU - Park, Jong Tae

AU - Ahn, Sung Gwe

AU - Jeong, Joon

AU - Kim, Seung Il

PY - 2018/7/1

Y1 - 2018/7/1

N2 - 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 patients who 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.

AB - 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 patients who 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.

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