Kayra CANGOZ, Firat CANLIKARAKAYA, Hikmet Pehlevan OZEL, Muhammed Bahadir AVCI, Seyma Kurtoglu OZER, Ersin Gurkan DUMLU, Ebru MENEKSE
The Medical Bulletin of Haseki - 2026;64(3):192-199
Aim: Despite advances in early detection and surgical de-escalation strategies in breast cancer, accurately predicting sentinel lymph node involvement (SLNI) among patients with T1 disease remains a clinical challenge, particularly in those with unfavorable histologic subtypes. In this context, this study aimed to examine clinical factors related to pathological SLNI among patients with T1 early-stage breast cancer (ESBC) and unfavorable histologic subtypes. Methods: This retrospective analysis included 128 patients with clinically node-negative T1 ESBC and unfavorable histology who underwent surgery between January 2010 and December 2020. Clinicopathological and preoperative laboratory parameters were analyzed. To identify the independent risk factors associated with SLNI, logistic regression analyses were performed. Results: Thirty-six (28.1%) patients were SLNI-positive, and 92 (71.9%) were SLNI-negative. In univariate analysis, the presence of lymph nodes with a thickened cortex on preoperative ultrasonography (p=0.016), lymphovascular invasion (LVI) (p=0.002), larger tumor size (p=0.002), and higher neutrophil levels (p=0.046) were significantly associated with SLNI positivity. SLNI-positive patients also demonstrated significantly lower serum albumin levels (p=0.002), while monocyte levels exhibited a tendency toward lower values (p=0.064). In multivariate analysis, serum albumin levels (p=0.015), neutrophil count (p=0.031), monocyte count (p=0.035), and LVI (p=0.040) remained independently associated with SLNI. Conclusion: Selected clinicopathological and inflammatory parameters were independently associated with SLNI in patients with T1 ESBC and unfavorable histology and may help identify patients at higher risk of nodal involvement.
