Analysis of Axillary Lymph Nodes in Breast Cancer Patients with Positive Sentinel Lymph Node Biopsy

Objective: To determine the prevalence of positive non-sentinel nodes (non-SLN) after axillary dissection for positive sentinel lymph node (SLN) and the relationship between occurrence of positive non-SLNs and penetration of the sentinel's capsule by malignant cells, as well as grade and molecular subtype of the breast cancer. Methods: An analysis was performed of a total of 77 patients with a positive SLN from a fiveyear period. Patients were categorized according to the following criteria: positivity of non-SLN, invasion of SLN capsule, tumour grade, T stage and molecular subtype. Results: In over 65% of patients, non-SLN were negative for metastases despite a positive SLN. A statistically significant correlation was observed between SLN capsule penetration and positive non-SLN metastases (p < 0.001). It was also observed that non-SLN metastases are more commonly positive in patients with a high tumour grade, high T stage, and HER2-positive and triple-negative tumours. Conclusion: Non-SLN metastases are generally found in patients with SLN capsule penetration by malignant cells, in those with poorly differentiated tumours (high grade), and in those with high T stage, as well as in triple-negative and HER2-positive tumours. Based on these findings, such patients should undergo axillary dissection due to an increased risk of non-SLN metastases.