Intramammary lymph node sentinel metastasis without metastasis in axilla. Axillary lymph node dissection or conservative surgery?

The sentinel lymph node biopsy is a standard treatment for patients with breast cancer and clinically negative axilla lymph node. The presence of an extra-axillary and intra-axillary (IM) sentinel lymph node (SLN) occurs in up to 2.6% of cases. In the presence of a metastatic IM SLN, axillary positi...

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Bibliographic Details
Published in:Revista Brasileira de ginecologia e obstetrícia 2012-10, Vol.34 (10), p.478
Main Authors: Vieira, René Aloisio da Costa, Viviani, Dionísio Nepomuceno, Ferreira, Suellen Strada, Bailão, Jr, Antônio, Kerr, Ligia Maria, Matthes, Angelo Gustavo Zucca, Moriguchi, Sonia Marta
Format: Article
Language:Portuguese
Subjects:
Adult
Axilla
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Female
Humans
Lymph Node Excision
Lymphatic Metastasis
Middle Aged
Sentinel Lymph Node Biopsy
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Summary:The sentinel lymph node biopsy is a standard treatment for patients with breast cancer and clinically negative axilla lymph node. The presence of an extra-axillary and intra-axillary (IM) sentinel lymph node (SLN) occurs in up to 2.6% of cases. In the presence of a metastatic IM SLN, axillary positivity may occur in up to 81% of cases. Due to the limited number of cases reported, there is no standard treatment for the association of metastatic SLN IM and non-metastatic axillary SLN . We add here two cases to the literature, one of them with metastatic disease in the axilla. The use of a nomogram demonstrated that the risk of axillary metastasis was less than 10% and the addition of these cases to the literature showed that in this situation the rate of axillary metastasis is 6.25%. We discuss the pros and cons of further axillary dissection in this situation.
ISSN:1806-9339