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10.1245/s10434-007-9694-z
Annals of Surgical Oncology 15:848-853 (2008)
© 2008 Society of Surgical Oncology
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Original Article

S-Classification of Sentinel Lymph Node Predicts Axillary Nonsentinel Lymph Node Status in Patients with Breast Cancer

Astrid Maria Fink, MD1, Harald Lass, MD2, Helmut Hartleb3, Wolfgang Jurecka, MD1, Heinrich Salzer, MD2 and Andreas Steiner, MD1

1 Department of Dermatology, Wilhelminenspital, Montleartstrasse 37, 1160, Vienna, Austria
2 Department of Obstetrics and Gynecology, Wilhelminenspital, Montleartstrasse 37, 1160, Vienna, Austria
3 Department of Pathology, Wilhelminenspital, Montleartstrasse 37, 1160, Vienna, Austria

Correspondence: Address correspondence and reprint requests to: Astrid Maria Fink, MD; E-mail: astrid.fink{at}wienkav.at

Background: One-half of breast cancer patients with positive sentinel lymph node (SN) have no further metastases in the axillary lymph node basin. The aim of the present study was to identify patients with positive SN who are unlikely to have further metastases in the axillary lymph node basin, using a new classification of SN, namely the S-classification.

Methods: Specimens of positive SN were subjected to a pathological review according to the previously published S-classification. S-stages of positive SN were correlated with the status of further metastases in the axillary lymph node basin after axillary lymph node dissection (ALND).

Results: Of 117 patients who underwent sentinel lymph node biopsy, 36 (30.8%) had a positive SN and were subjected to level I and II ALND. The occurrence of positive nonsentinel nodes was significantly related to the S-stage of SN. No patient with stage SI had additional metastases in the nonsentinel lymph nodes, while 14.3% of patients with SII stage disease and 60.9 % of patients with SIII disease had other non-SN that were metastatic.

Conclusion: S-stages of positive SN are highly predictive for axillary nonsentinel node status. Especially patients with SI sentinel node metastases appear to be at low risk for further nonsentinel node metastases.

Key Words: Breast cancer • Sentinel lymph node • Axillary lymph node dissection • S-classification






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