Predictors of Positive Axillary Node Clearance Following Positive Sentinel Node Biopsy: A Retrospective Analysis

Background Axillary management in breast cancer is increasingly de-escalated. This study assessed whether sentinel node biopsy (SNB) histological features predict further axillary disease. Methods A retrospective single-centre study was performed of patients with primary breast cancer who underwent axillary node clearance (ANC) following a positive SNB. Sentinel node deposit size and extracapsular spread were analysed using t-tests and chi-square testing. Logistic regression with receiver operating characteristic analysis was used to evaluate deposit size as a predictor of positive ANC. Results Forty-two patients were included, of whom 23 (55%) had further nodal metastases. Larger SN deposits were associated with positive ANC (p=0.020). Logistic regression identified deposits <3 mm as predictive of no further axillary disease. Extracapsular spread was also significant (p=0.042). Conclusions These findings support selective axillary de-escalation, although validation in larger prospective studies is required.