Older age independently predicts a lower risk of sentinel lymph node metastasis in breast cancer.

Abstract

The influence of patient age on the risk of sentinel lymph node (SLN) metastasis in breast cancer has not been defined. A breast cancer SLN database was analyzed. Factors associated with SLN metastasis were assessed by multiple logistic regression modeling. Age, T stage, estrogen receptor status, HER-2/neu status, grade, angiolymphatic invasion, lobular histology, tubular/mucinous histology, and the number of SLNs resected were assessed. Data were available for 810 patients with invasive breast cancer. SLN metastasis was observed in 22% of the patients. The factors most strongly associated with SLN metastasis were angiolymphatic invasion, T stage, and age. Age ranged from 29 to 95 years. The median age was 66 years. Overall, SLN metastasis was more common in younger patients (< or =66 years) than in older patients (>66 years; P < .001). Among patients without angiolymphatic invasion, SLN metastasis was nearly twice as common in the younger patients as in the older patients. The effect of angiolymphatic invasion as a risk for SLN metastasis was much greater in the older age group. In addition to known risk factors, age independently predicts the risk of SLN metastasis in breast cancer. Angiolymphatic invasion seems to be a more powerful predictor of SLN metastasis in older patients.