Macrometastasis at selective lymph node biopsy: A practical going-for-the-one clinical scoring system to personalize decision making

Table 1 Characteristics of the 95 patients with sentinel lymph nodes with macrometastases

Characteristics	n = 95	%
Age (range), yr	51.9 (23-82)	-
Average tumor size, mm	17.4	-
Tumor size
0-10	14	14.7
11-15	25	26.3
16-20	26	27.4
21-30	18	18.9
31-40	6	6.3
> 50	1	1.1
In situ	5	5.3
Menopausal status
Pre	50	52.6
Post	45	47.4
Histology type
Ductal	76	80
Lobular	15	15.8
Others	4	4.2
Phenotype
Luminal	83	87.4
Basal	9	9.5
Her-2	3	3.2
Grade
I	16	16.8
II	54	56.8
I + II	70	73.7
III	24	25.3
Unknown	1	1.1
Surgery
Conservative	63	66.3
Mastectomy	32	33.7
Number of SN removed
1	35	36.8
2	28	29.5
3	20	21.1
≥ 4	12	12.6
Nº of positive SN (Mic + MAC)
0	4	4.2
1	65	68.4
2	20	21.1
3	4	4.2
≥ 4	2	2.1
Size of the SLN metastasis
ITC (i+)	0	0
Micrometastasis (Mic)	0	0
Macrometastasis (MAC)	95	100
Number of positive SLN
0	55	57.9
1	21	22.1
2-3	11	11.6
1-3	32	33.7
≥ 4	8	8.4
Adjuvant treatments
Radiotherapy	75/90	82.4
Chemotherapy	72/90	80
Hormonotherapy	79/90	87.7
Immunotherapy	4/92	4.3

SLN: Sentinel lymph nodes.

Table 2 Univariate analysis of 95 patients with presence of sentinel lymph nodes with macrometastases

	No additional metastatic lymph nodes	Additional metastatic lymph nodes	P value
Age
< 40	66%	44%	0.04
≥ 40	32.6%	67.4%
Hormonal status
Premenopausal	70%	30%	NS
Postmenopausal	60%	40%
T stage
T1	75.8%	24.2%	< 0.05
T2	47%	53%
T3	0	100%
Tumor size
≤ 15 mm	85%	15%	< 0.05
> 15 mm	49%	51%
Histologic type
Ductal carcinoma	67.1%	32.9%	NS
Lobular carcinoma	47%	53%
Grade
I + II	68.6%	31.4%	NS
III	54%	46%
Molecular subtype
Luminal A/B	65.6%	34.4%	< 0.05
Basal	22.2%	77.8%
HER2	100%	0
LVI
Present	66.7%	33.3%	NS
Absent	61.5%	38.5%
Number of positive SLN
1	69.6%	31.4%	< 0.05
≥ 2	43.7%	66.3%
ACOSOG Z0011 criteria
≤ 2 SLN+	68.5%	31.5%	< 0.05
> 2 SLN+	16%	84%

LVI: Lymphovascular invasion; NS: Not significant; SLN: Sentinel lymph nodes.

Table 3 Multivariate analysis of 95 patients with sentinel lymph nodes with macrometastases

		P value	Odds ratio
Tumor size	≤ 15 mm vs > 15 mm	0.002	2.004
Number of metastatic SLN	1 vs > 1	0.021	2.573
ACOSOG Z0011 criteria	≤ 2 SLN+ vs > 2 SLN+	0.045	10.195

SLN: Sentinel lymph nodes.

Table 4 Univariate analysis of variables related to the presence of additional disease on completion axillary lymph node dissection in the group of 79 cases with presence of only one macrometastatic sentinel lymph nodes

	Additional metastatic lymph nodes, n = 79
Age
< 40	50%
≥ 40	28%
≤ 15 mm	85%
> 15 mm	49%
Histologic type
Ductal carcinoma	28%
Lobular carcinoma	50%
Mucinous	0
Tumor size
≤ 10 mm	7%
11-15 mm	10%
16-20 mm	42%
> 20 mm	47%
Grade
DCIS	0
I	18%
II	31%
III	45%
Molecular subtype
Luminal A/B	28%
Basal	55%
HER2	0