Lymphovascular invasion is a significant risk factor for non-sentinel nodal metastasis in breast cancer patients with sentinel lymph node (SLN)-positive breast cancer: a cross-sectional study

World J Surg Oncol. 2023 Dec 14;21(1):386. doi: 10.1186/s12957-023-03273-6.

Abstract

Background: A connection between lymphovascular invasion and axillary lymph node metastases in breast cancer has been observed, but the findings are inconsistent and primarily based on research in Western populations. We investigated the association between lymphovascular invasion and non-sentinel lymph node (non-SLN) metastasis in breast cancer patients with sentinel lymph node (SLN) metastasis in western China.

Methods: This study comprised 280 breast cancer patients who tested positive for SLN through biopsy and subsequently underwent axillary lymph node dissection (ALND) at The People's Hospital of Guangxi Zhuang Autonomous Region between March 2013 and July 2022. We used multivariate logistic regression analyses to assess the association between clinicopathological characteristics and non-SLN metastasis. Additionally, we conducted further stratified analysis.

Results: Among the 280 patients with positive SLN, only 126 (45%) exhibited non-SLN metastasis. Multivariate logistic regression demonstrated that lymphovascular invasion was an independent risk factor for non-SLN in breast cancer patients with SLN metastasis (OR = 6.11; 95% CI, 3.62-10.32, p < 0.05). The stratified analysis yielded similar results.

Conclusions: In individuals with invasive breast cancer and 1-2 positive sentinel lymph nodes, lymphovascular invasion is the sole risk factor for non-SLN metastases. This finding aids surgeons and oncologists in devising a plan for local axillary treatment, preventing both over- and undertreatment.

Keywords: Axillary lymph node dissection; Breast cancer; Lymph nodes metastases; Lymphovascular invasion.

Publication types

  • Review

MeSH terms

  • Axilla / pathology
  • Breast Neoplasms* / pathology
  • Breast Neoplasms* / surgery
  • China
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lymph Node Excision
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphadenopathy* / pathology
  • Lymphatic Metastasis / pathology
  • Risk Factors
  • Sentinel Lymph Node Biopsy / methods
  • Sentinel Lymph Node* / pathology
  • Sentinel Lymph Node* / surgery