RT Journal Article SR Electronic T1 Additional Nodal Disease Prediction in Breast Cancer with Sentinel Lymph Node Metastasis Based on Clinicopathological Features JF Anticancer Research JO Anticancer Res FD International Institute of Anticancer Research SP 2109 OP 2117 VO 38 IS 4 A1 PAOLO ORSARIA A1 EMANUELE CAREDDA A1 FEDERICA GENOVA A1 MARCO MATERAZZO A1 ILARIA CAPUANO A1 GIANLUCA VANNI A1 ALESSANDRA VITTORIA GRANAI A1 ADRIANO DE MAJO A1 ILARIA PORTARENA A1 PIERPAOLO SILERI A1 GIUSEPPE PETRELLA A1 LEONARDO PALOMBI A1 ORESTE CLAUDIO BUONOMO YR 2018 UL http://ar.iiarjournals.org/content/38/4/2109.abstract AB Aim: The standard-of-care in breast cancer (BC) with positive sentinel lymph node (SLN) metastasis includes complete axillary lymph node dissection (ALND); however, almost half of such cases have no further tumor burden. This study aimed to assess the clinicopathological factors that predict non-SLN metastasis to define subgroups of SLN-positive patients in whom the axilla may be staged by SLN biopsy alone, while avoiding unnecessary overtreatment. Patients and Methods: The records of 191 patients with histologically-proven primary BC who underwent a positive (SLN) biopsy between 2005 and 2017 were reviewed. Patients with at least one tumor-involved SLN who underwent completion ALND were enrolled. Demographic and clinicopathological characteristics, including age, primary tumor size and histological grade, lymphovascular invasion, ratio of positive SLNs to the harvested SLNs, SLN metastasis size, and molecular subtype classification according to immunohistochemical biomarker status [estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2)], were evaluated. Data were collected retrospectively and analyzed using the Mann–Whitney and Chi-square tests (statistical significance: p<0.05). Results: The incidence of non-SLN metastasis associated with positive SLN was 48.6% (93/191). The risk of additional nodal spread correlated with high sentinel nodal ratio >0.67 [odds ratio (OR)=2.55, p=0.032], luminal BC subtype (OR=2.67, p=0.06), HER2 overexpression (OR=0.4, p=0.016), and ER+PR−HER2− profile (OR=2.95, p=0.027). There was a tendency (statistically insignificant; p>0.05) toward higher incidence of non SLN metastasis with increasing age and histological grade, which could be attributed to the small sample size. Conclusion: According to this study, sentinel nodal ratio and BC subtypes as per ER, PR, and HER2 status significantly predicted the likelihood of additional lymphatic involvement. Validation of these parameters in prospective studies is indicated, and may help individualize treatment modalities.