Prognostic Implications of Positive Nonsentinel Lymph Nodes Removed During Selective Sentinel Lymphadenectomy for Breast Cancer

: Nonsentinel lymph nodes (SLNs) are commonly removed at the time of selective sentinel lymphadenectomy (SSL). Their predictive value for the rest of the nodal basin is unknown. A retrospective review of 436 breast cancer patients who underwent SSL between 12/97 and 04/03 at a single institution. One‐hundred nineteen patients had non‐SLNs removed at SSL; eight were positive (6.7%). Positive non‐SLNs predicted that SLNs would also be positive (p = 0.008). There was no difference in rates of additional positive nodes found on completion axillary node dissection between the non‐SLN and SLN positive patients (p = 0.62). After adjustment for covariates, the presence of positive non‐SLNs was not associated with poorer disease free survival (p = 0.24), time to systemic recurrence (p = 0.57), or overall survival (p = 0.70). Positive non‐SLNs removed during SSL are not a significant risk factor for additional positive nodes on completion axillary nodal dissection (CALND) or for worse survival than positive SLNs.