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Background: In this multi-institutional prospective study, we evaluated whether we could identify risk factors predictive for non-sentinel lymph node (non-SN) metastases in breast cancer patients with a positive sentinel lymph node (SN).

Methods: In this multi-institutional study, 541 eligible breast cancer patients were included prospectively.

Results: The occurrence of non-SN metastases was related to the size of the SN metastasis (P = .

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