FACTORES CLÍNICO-PATOLÓGICOS EN CÁNCER DE MAMA RELACIÓN CON METÁSTASIS EN GANGLIOS NO CENTINELAS AXILARES CUANDO EL CENTINELA ES POSITIVO

Abstract

OBJECTIVE: Our aim was to determine which clinic pathologic factors can predict involve of non sentinel lymph nodes when the sentinel lymph node biopsy is positive, so to omit the axillaries lymph node dissection. METHODS: The data of all patients with invasive breast carcinoma, between 2000 and April 2010, who underwent (271), was reviewed. We excluded the patients who received neo adjuvant therapy, remaining 219 patients. Univariate (Chi square test), and multivariate analysis in a logistical regression model was used to establish the association within some clinic pathologic factors and involve of non sentinel nodes in the group of patients with positive RESULTS: Positive sentinel was found in 44 patients (20.%). Non sentinel positive lymph nodes were recorded in 22 (50 %). Nuclear grade III, lymph vascular invasion and number of positive sentinel nodes (2 or more) were associated with residual axillaries disease in the univariate analysis. In the multivariate analysis only lymph vascular invasion was an independent predictor of metastases in non sentinel lymph nodes. CONCLUSION: Lymph vascular invasion enhances the chance of axillaries residual disease in patients with positive biopsy. The residual disease after positive biopsy is significant (50 %).We can´t find a group of factors that could help to decide in which patients we can omit the axillaries dissection. There is some evidence that chemotherapy and radiotherapy can control axillaries residual disease. Even in this context all patients with positive sentinel biopsy must undergo axillaries dissection.