Abstract P4-02-13: Comparison of lymph node ultrasound and pathological characteristics of breast cancer patients with positive and negative sentinel lymph node
Authors: Wang Xuefei , Wu Shafei , Zhang Guochao , Li Jiaxin , Du Jianhua , Zhou Yidong , Mao Feng , Lin Yan , Shen Songjie , Zhang Xiaohui , Sun Qiang 
Published: March 2020

Background: Few data exist to elucidate sentinel lymph node (SLN) status in breast cancer patients who have a suspicious axillary lymph node (ALN) at ultrasound but a negative clinical physical examination. This study compared various ALN statuses in the breast cancer patients who have a suspicious axillary lymph node (ALN) at ultrasound but a negative clinical physical examination to guide further ALN management.

Methods: From Jan 1st 2014 to Jan 1st 2019 in PUMCH (Peking Union Medical College & Hospital), breast cancer patients who had a suspicious axillary lymph node (ALN) at ultrasound but a negative clinical physical examination and treated with sentinel lymph node (SLN) biopsy were retrospectively analyzed. The SLN status, and SLN positive rate in the entire population were analyzed. Lymph node ultrasound and pathological characteristics were compared between patients with positive SLNs and negative SLNs.

Results: A total of 483 breast cancer patients (365 SLN negative and 118 SLN positive) were eligible for the final analysis, the SLN positive rate in the enrolled entire population was 32.33%, while in DCIS (Ductal carcinoma in situ) subgroup the SLN positive rate was 12.26%. The patients’ lymph node ultrasound and basic clinical pathological characteristics are listed in table 1. The histology type (P = 0.000), ultrasound lymph node shape (P = 0.000), ultrasound lymph node CMD (corticomedullary demarcation) (P = 0.000), ultrasound lymph node blood flow (P = 0.034) and PR status (P=0.004) had statistical significance between the positive SLNs group and negative SLNs group.

Conclusions: 1/3 patients with a suspicious ALN at ultrasound but a negative clinical physical examination had ALN metastasis. IDC, PR positive, ultrasound LN with irregular shape, unclear CMD and blood flow are more likely to have positive SLN.

Table 1. Lymph node ultrasound and basic clinical pathological characteristics between SLN negative and positive groupSLN negativeSLN positiveP valuen=365n=118Age(Year)50.14±11.6848.19±10.420.088Histology Type0.000DCIS10613IDC259105Ki67(%)30.69±24.3131.02±23.260.898Ultra-LN Size (cm)1.42±0.691.30±0.730.111Ultra-LN Shape0.000regular359108irregular610Ultra-LN CMD0.000clear32690unclear3928Ultra-LN Blood0.034presence21155absence15463T stage0.071I22779II13133III76ER0.141positive26694negative9924PR0.004positive23292negative13326Her20.067positive10925negative25693Abbreviation:DCIS (Ductal carcinoma in situ); IDC (Invasive ductal carcinoma); Ultra-LN (Ultrasound of lymph node); Ultra-LN CMD (Corticomedullary demarcation in lymph node ultrasound); Ultra-LN Blood (Blood flow in lymph node ultrasound).

Citation Format: Xuefei Wang, Shafei Wu, Guochao Zhang, Jiaxin Li, Jianhua Du, Yidong Zhou, Feng Mao, Yan Lin, Songjie Shen, Xiaohui Zhang, Qiang Sun. Comparison of lymph node ultrasound and pathological characteristics of breast cancer patients with positive and negative sentinel lymph node [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-02-13.