Prognosis of women with breast cancer and sentinel lymph node micrometastases.

Czech version

Authors: P. Strnad ¹; Lukáš Rob ¹; P. Škapa ²; H. Stankušová ³; K. Michalová ⁴; J. Chod
Authors‘ workplace: Gynekologicko-porodnická klinika 2. LF UK a FN Motol ¹; Ústav patologie a molekulární medicíny 2. LF UK a FN Motol ²; Radioterapeuticko-onkologické oddělení 2. LF UK a FN Motol ³; Klinika nukleární medicíny 2. LF UK a FN Motol ⁴
Published in: Prakt Gyn 2009; 13(4): 218-223

Overview

The advent of sentinel lymph node biopsy and improvements in histopathological and immunohistochemical analysis has increased the rate at which micrometastases are identified. However their significance has been the subject of much debate. Published studies have reported divergent results regarding the significance and implications of axillary lymph node micrometastases. Some studies demonstrate no associations, whilst others have found these to be indicators of poor prognosis, associated with non‑SLN involvement, in addition to local and distant failure. The objective of our study was to evaluate the impact of sentinel lymph node micrometastatic cancer to prognosis of the disease. From January 2000 to December 2006 in 89 cases with sentinel axillary node negative cancer we reexamined the axillary tissue blocks by serial sectioning, haematoxilin‑eosin staining and immunohistochemistry. Additional 13 cases of micrometastatic sentinel node involvement detected by frozen section were included. The overall and disease free survivals of patients with sentinel negative status (N0– 69 cases) and with sentinel node micrometastases (Nmic‑ 33 cases) were evaluated. The median follow‑up was 46 months (12– 96 months). Micrometastases (Nmic) were found in 20 cases (22,5 %). From the group of 69 nodes negative patients (N0) in 10 cases (14,5 %) developed tumor recurrence and from the group of 33 Nmic in 3 cases developed tumor recurrences (9,1 %). In the group of N0 patients developed 2 regional recurrences and 4 patients died, but 3 of them died of other causes. In the group of Nmic developed one regional recurrence and one patient died of generalization of disease. Our study demonstrated that the presence of sentinel node micrometastases is not associated with worsening of the disease.

Key words:
micrometastases – sentinel lymph node – breast cancer

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Article was published in

Practical Gynecology

2009 Issue 4