Extracapsular extension in the positive sentinel lymph node: a marker of poor prognosis in cT1-2N0 breast cancer patients?

Marissa L. G. Vane*, Maria A. Willemsen, Lori M. van Roozendaal, Sander M. J. van Kuijk, Loes F. S. Kooreman, Sabine Siesling, Hans H. W. de Wilt, Marjolein L. Smidt

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


ObjectiveThis study aims to evaluate whether extracapsular extension (ECE) in the sentinel lymph node (SLN) is associated with involvement of 4 lymph node metastases at completion axillary lymph node dissection (ALND) and the effect on 5-year disease-free survival (DFS) and 10-year overall survival (OS).Summary background dataECE in a SLN is usually a contraindication for omitting completion ALND in cT1-2N0 breast cancer patients treated with breast-conserving therapy and 1-2 positive SLN(s).MethodsAll cT1-2N0 breast cancer patients with 1-3 positive SLN(s) who underwent ALND between 2005 and 2008 were selected from the Netherlands Cancer Registry. Logistic regression analysis was used to determine the association between ECE and 4 lymph node metastases. Five-year DFS and 10-year OS were analyzed using Kaplan-Meier survival analysis. Cox regression analysis was performed to correct for other prognostic factors.ResultsA total of 3502 patients were included. Information on ECE was available for 2111 (60.3%) patients, consisting of 741 (35.1%) patients with and 1370 (64.9%) without ECE. The incidence of 4 lymph node metastases was 116 (15.7%) in the ECE group vs. 80 (5.8%) in the group without ECE (p

Original languageEnglish
Pages (from-to)711-718
Number of pages8
JournalBreast Cancer Research and Treatment
Issue number3
Publication statusPublished - Apr 2019


  • Breast cancer
  • Sentinel lymph node
  • Axillary lymph node dissection
  • Extracapsular extension
  • Disease-free survival
  • Overall survival

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