Clinical importance of micrometastasis in sentinel lymph nodes

Abstract Introduction We evaluated the incidence of micrometastasis and nonsentinel lymph node metastasis as well as local and axillary recurrence rates after level I–II axillary lymph node dissection. Materials and methods Patients ( n = 760) with early-stage breast cancer underwent sentinel lymph...

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Bibliographic Details
Published in:Breast (Edinburgh) 2011-02, Vol.20 (1), p.31-33
Main Authors: Ozcinar, Beyza, Muslumanoglu, Mahmut, Igci, Abdullah, Gurdal, Sibel O, Yavuz, Ekrem, Kecer, Mustafa, Dagoglu, Temel, Ozmen, Vahit
Format: Article
Language:English
Subjects:
Adult
Aged
Axilla - surgery
Axillary lymph node dissection
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Female
Hematology, Oncology and Palliative Medicine
Humans
Isolated tumor cells
Local recurrence
Lymph Node Excision
Lymph Nodes - pathology
Lymphatic Metastasis
Micrometastasis
Middle Aged
Neoplasm Recurrence, Local - pathology
Neoplasm Staging
Prognosis
Retrospective Studies
Sentinel Lymph Node Biopsy
Tumor Burden
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Summary:Abstract Introduction We evaluated the incidence of micrometastasis and nonsentinel lymph node metastasis as well as local and axillary recurrence rates after level I–II axillary lymph node dissection. Materials and methods Patients ( n = 760) with early-stage breast cancer underwent sentinel lymph node biopsy, and 45 patients (6.0%) with micrometastasis (0.2–2.0 mm) were included in this study. Data concerning tumor, patients’ characteristics and adjuvant treatments were recorded. Results The median age was 46 (26–67) years, median breast tumor size was 20 (1–50) mm, and median number of excised sentinel lymph nodes were 2 (1–5). All patients with micrometastasis underwent further level I–II axillary lymph node dissection. Eleven of 45 (24.4%) patients with micrometastasis in their sentinel lymph node biopsy had nonsentinel lymph node metastasis after an axillary lymph node dissection. There was no factor related to nonsentinel lymph node metastasis. Stage migration occurred in 4 of 45 patients (8.8%) due to the detection of micrometastases or macrometastases in nonsentinel lymph nodes. Discussion The classical treatment after detection of micrometastasis in sentinel lymph nodes is further axillary dissection. However, nonrandomized, nonprospective studies with 4–5 years follow up showed 0.6% axillary recurrence without further axillary lymph node dissection, although we still need the results of randomized controlled studies.
ISSN:0960-9776
1532-3080
DOI:10.1016/j.breast.2010.08.005