The Diagnostic Value of the Modified mSIS Score in Predicting Sentinel Axillary Lymph Node Positivity in Patients with Early-Stage Breast Cancer

Abstract

Axillary lymph node metastasis is the most important prognostic factor in breast cancer. No method exists to diagnose the metastasis of the axillary lymph nodes before surgery.  Sentinel lymph node biopsy is a procedure for axillary staging. Hematological parameters and systemic inflammation play a role in cancer metastasis. This study aims to evaluate the modified Systemic Inflammation Score (mSIS) score predicting sentinel axillary lymph node positivity in early breast cancer patients and to determine if there is a need to modify it. This is a retrospective study conducted in Ankara City Hospital General Surgery Department from March 2019 to July 2021.  One hundred fifty-nine patients were analyzed according to age, albumin parameters, Thrombocyte, Lymphocyte and Monocyte count, histopathological type of cancer, and lymph node metastasis status. The collected information was entered into SPSS 24.0 program. Lymph node metastasis was detected in 51 of these 159  patients. Results showed no significant difference between the lymph node metastasis group and no lymph node metastasis group after applying the mSIS score to each group. This result is due to normal albumin levels in early breast cancer patients. Platalet lymphocyte ratio (PLR) is associated with lymph node metastasis in breast cancer. PLR is applied to mSIS score instead of albumin.The  new modified early-stage breast cancer SIS(mebcSIS) was established as follows: Score 0: LMR ≥ 5.7 and PLR < 141, Score 1: LMR < 5.7 or PLR ≥ 141, Score 2: LMR < 5.7 or PLR ≥ 141. The relationship between mebcSIS and LNM was statistically significant (p = 0.003). There is a positive correlation between mebcSIS score and lymph node metastasis in early breast cancer patients.