engleski

Histologic detection of additional nodal metastases in breast carcinoma with positive sentinel node

Axillary lymph node dissection (ALND) is an important procedure in the staging of breast cancer patients. A lymph node defined as sentinel lymph node (SLN) would be the first to receive tumoral drainage. The aim of this study was to estimate the likelihood of additional disease in the axilla after SLN mapping. A total of 259 breast carcinomas and SLN biopsies followed by ALND were examined. The patient median age was 59 years, approximately 75% of them postmenopausal. Tumor size was 1.4±0.8 cm (almost 80% in pT1). SLNs were positive in 59 of 259 (22.8%) carcinomas, 30 (11.6%) with micrometastases (<2.0 mm) and 29 (11.2%) with metastases. Tumor size (p=0.004) and presence of lymphovascular invasion (LVI) (p=0.034) were found to be significant predictors of pathologically positive SLN. Positive non-SLNs were present mostly in patients with metastasis >2 mm in SLN (p=0.003), in carcinoma with higher nuclear grade (p=0.044), decreased ER (p=0.042), and PR (p=0.042). Finally, lymph node status (pN) following SLN and ALND was found to be significantly associated with tumor size (p=0.006), LVI (p=0.037), PR (p=0.023) and Her-2 status (p<0.001). These results point to detailed analysis of primary tumor and SLN that may increase the precision of patient selection for further axillary surgery or radiotherapy.

additional lymph node metastases; breast carcinoma; Sentinel lymph node

DOI 10.1007/s00428-009-0805-z