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Erschienen in: Annals of Surgical Oncology 10/2016

23.06.2016 | Breast Oncology

Impact of Body Mass Index on Clinical Axillary Nodal Assessment in Breast Cancer Patients

verfasst von: Damian McCartan, MD, Michelle Stempel, MPH, Anne Eaton, MS, Monica Morrow, MD, Melissa Pilewskie, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 10/2016

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Abstract

Background

More than one-third of American adults are obese, and an elevated body mass index (BMI) is postulated to reduce the sensitivity of the clinical evaluation of the axilla. Clinical nodal examination is important in allocating breast cancer patients to appropriate axillary management. This study sought to determine whether BMI influences the rate of nodal positivity in women designated clinically as node-negative (cN0) by physical examination.

Methods

Breast cancer patients deemed cN0 who underwent sentinel lymph node biopsy (SLNB) from February 2006 to December 2011 were identified from a prospectively maintained database. Clinicopathologic features including BMI and axillary surgery results were recorded and compared among pathologically node-negative and node-positive patients.

Results

Overall, 5142 cN0 patients underwent 5262 SLNB procedures during the study period. Nearly one-third of the patients (28 %) were obese (BMI, >30 kg/m2). A positive SLN was identified in 25 % of the patients, and 84 % proceeded to axillary lymph node dissection. Predictors of SLN positivity included younger age, larger tumor size, high nuclear grade, multifocality, and lymphovascular invasion. An increased BMI did not correlate with a higher likelihood of SLN positivity (p = 0.6). The likelihood of cN0 patients having a high burden of axillary metastases (>3 positive nodes) was 4 % overall and, similarly, did not differ according to BMI (p = 0.4).

Conclusion

Elevated BMI was not associated with a higher likelihood of SLN positivity or heavy nodal disease burden among women staged as cN0 by physical exam. These findings indicate that physical examination is appropriate and sufficient for preoperative axillary evaluation of women undergoing initial surgery regardless of patient BMI.
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Metadaten
Titel
Impact of Body Mass Index on Clinical Axillary Nodal Assessment in Breast Cancer Patients
verfasst von
Damian McCartan, MD
Michelle Stempel, MPH
Anne Eaton, MS
Monica Morrow, MD
Melissa Pilewskie, MD
Publikationsdatum
23.06.2016
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 10/2016
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5330-0

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