Abstract
The potential morbidity of an axillary lymph node dissection in patients with breast cancer can be avoided in patients with a negative sentinel node (SN). It may be possible to identify a subset of patients with a positive SN and without metastases in the remaining axillary lymph nodes. Case-control study. Both primary and referral hospital care. Data were studied for 255 consecutive patients with stage T1 or T2 breast cancer who had a successful identification of the SN. In patients with a positive SN, histological examination of all non-SNs that were negative by routine examination was the same as that for SNs (multiple sectioning and immunohistochemical analysis). The incidence of non-SN metastases was correlated with the surface area and number of SN metastases and primary tumor characteristics. A micrometastasis was defined as less than 1 mm(2). Of 255 patients, the SN appeared to be positive in 93 (36%). Subsequent axillary lymph node dissection revealed positive non-SNs in 46 patients (49%). Patients with a single positive SN and patients with metastases less than 1 mm(2) in the SN had significantly less non-SN involvement than patients with more than 1 positive SN (40% vs. 78%) and patients with macrometastases (27% vs. 49%). The incidence of non-SN metastases seemed to be related to the number of positive SNs and the size of SN metastases. However, in the group of patients with a positive SN, it was not possible to identify a subset of patients without non-SN metastases
Original language | English |
---|---|
Pages (from-to) | 1059-1063 |
Journal | Archives of surgery (Chicago, Ill. |
Volume | 136 |
Issue number | 9 |
DOIs | |
Publication status | Published - 2001 |