Factors influencing the number of sentinel lymph nodes identified in patients with breast cancer

Anees B. Chagpar, David J. Carlson, Alison L. Laidley, Souzan E. El-Eid, Terre Q. McGlothin, Robert D. Noyes, Phillip B. Ley, Todd M. Tuttle, Kelly M. McMasters

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Although the sentinel lymph node (SLN) is defined as the first node draining a tumor, multiple nodes are often identified. Few SLNs are required for adequate staging; removal of more may be unnecessary. The objective of this study was to determine factors influencing the number of SLN identified. Methods: The University of Louisville Breast Sentinel Lymph Node Study was used to determine correlates of identifying greater than 4 SLNs by using univariate and multivariate analyses. Results: An SLN was identified in 3,882 of 4,131 patients (94%). The median number of SLN identified was 2 (range 1-18); 90% had ≤4 SLNs identified. Palpable tumors, surgeon inexperience, and dermal injection were associated with greater than 4 SLNs identified. All 3 of these factors remained significant on multivariate analysis. Conclusions: Palpable tumors often have greater than 4 SLNs identified, and the use of intradermal injection increases this probability.

Original languageEnglish (US)
Pages (from-to)860-865
Number of pages6
JournalAmerican journal of surgery
Issue number6
StatePublished - Dec 1 2007


  • Breast cancer
  • Identification
  • Sentinel lymph node


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