The Size of Metastasis in the Sentinel Node Is a Predictor of Additional Non-Sentinel Node Positivity
716
ministration of adjuvant systemic therapy known to re-
duce locoregional recurrence. Patients who do not re-
ceive radiation and adjuvant systemic therapy may not
achieve the same results as in the Z0011 trial and may
still benefit from additional scrutiny of their axillary
nodal status.
5. Conclusion
The present study demonstrates a significant correlation
between the size of tumor in the SLN and axillary me-
tastasis to non-SLN in patients with pT1 breast cancer.
The size of the SLN metastasis is an important risk factor
even among early breast lesions. Although the strength of
association is strongest for patients with macrometastasis,
our data suggests that patients with either micro or mac-
rometastasis in their SLN biopsies have an increased
likelihood of additional nodal positivity. This has impor-
tant therapeutic implications given the recent trend to-
wards minimizing axillary interventions in perceived low
risk subpopulations. The findings of this study suggest
patients with pT1 lesions and large volumes of SLN tu-
mor should be considered for closer follow-up and more
aggressive axillary management strategies.
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