engleski

Impact of sentinel lymph node biopsy on breast cancer follow-up

Aim: The purpose of this study was to evaluate the impact of sentinel lymph node biopsy (SLNB) results on follow-up of patients with breast cancer. Patients and methods: SLNB results obtained between years 2007-2011. from 702 patients with breast cancer, mean age 58.7±9.3 years, were analysed and categorized according to the presence and size of metastases as well as pathohistological type and stage of primary tumour. During follow-up until January 2014., PET-CT scan was requested by oncologist in 53 cases. Results: Out of 704 SLNB (2 patients with biopsies on both breasts), positive SLN involvement resulted in 199 (28.27%), while in 503 (71%) pts was negative. In 163 positive pts (81.9%), the cancer was qualified as invasive ductal, in 28 (14.1%) as invasive lobular, in 5 (2.5%) as mixed invasive, in 2 (1%) as ductal in situ, and 1 patient (0.5%) was diagnosed with lobular in situ type. Tumour stage was determined to be T1 in 95 (55.6%), T2 in 66 (38.6%), T3 in 5 (2.9%), T4 in 4 (2.3%), and „in situ“ in 1 patient (0.6%).Out of 171/199 cases (with single SLNB performed), micrometastases (SLNμM) were found in 57, while 114 had metastases greater than 2 mm (SLNM). Out of those with SLNμM, T1 stage was confirmed in 40 (70.2%), and T2 in 16 (28.1%) respectively ; while among those with SLNM, T1 stage was determined in 55 (48.2%), and T2 in 50 (43.9%), respectively. In more than 4 years of follow-up, in 22 out of 199 positive patients (11.06%) 18FFDG PET-CT was performed, and was positive for cancer progression in 14 (two thirds), 2 of which had SLNμM. In 503 SLNB negative pts PET-CT was done in 31 (6.16%), and progression was found in 11 (one third). Conclusion: In patients with SLNμM, T1 stage of breast cancer was predominant (70%), while almost equal proportion of T1 and T2 stages was found in those with SLNM , indicating that larger primary tumours are more likely either to be associated with bigger SLN metastases or to spread by lymphatic invasion. During follow- up, SLN positive patients were also referred to PET-CT scan twice as often as those free of SLN metastases, with double rate of positive findings in terms of disease progression. These results confirm the long term importance of SLN biopsy in women diagnosed in early stage of the disease, while prognostic value of SLNμM in long term follow-up remains to be further investigated.

Breast Neoplasms ; Sentinel Lymph Node ; micrometastasis

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