[Prevalence of micrometastases and isolated tumor cells in the sentinel node at early stage breast cancer].

Autor: Cordero García JM; Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, España. jmcordero@sescam.jccm.es, Palomar Muñoz A, Delgado Portela M, García Vicente AM, Pilkington Woll JP, Poblete García VM, Bellón Guardia ME, Pardo García R, Rabadán Ruiz L, Soriano Castrejón A
Jazyk: Spanish; Castilian
Zdroj: Revista espanola de medicina nuclear e imagen molecular [Rev Esp Med Nucl Imagen Mol] 2012 Mar-Apr; Vol. 31 (2), pp. 78-82. Date of Electronic Publication: 2011 Jun 11.
DOI: 10.1016/j.remn.2011.04.008
Abstrakt: Aim: To analyze the prevalence of isolated tumor cells (ITC) and micrometastases in the sentinel node of early stage breast cancer.
Material and Methods: A total of 234 patients diagnosed of breast cancer, stages T1 or T2, with no axillary involvement detected by palpation or ultrasound-FNA, were studied. The sentinel node (SN) was identified by lymphoscintigraphy and removed in the operating room. Serial sections and immunohistochemical staining were then performed, classifying them as negative (SN-), negative with ITC (SN-ITC), positive with micrometastases (SN+mic) and positive with macrometastases (SN+mac). A complete axillary lymphadenectomy (CAL) was carried out in those cases with micro- or macrometastases, the former being classified as negative (CAL-), positive with micrometatases (CAL+mic), and positive with macrometastases (CAL+mac). The follow-up ranged from 6-71 months.
Results: ITC were found in 12 patients (5.1%) and micrometastases in 24 (10.3%). Thus, a total of 36 patients were affected by some of these conditions (15.4%). In the group with micrometastases, the result of CAL was CAL- in 19/24 (79.1%), CAL+mic in 2 (8.3%) and CAL+mac in 3 (12.5%). No axillary recurrences have occurred up to date.
Conclusions: ITC and micrometastases were found in the sentinel node in a significant percentage of patients in the early stages of breast cancer. The low percentage of further axillary invasion in the group of micrometastases may open up the possibility of avoiding CAL in favor of other adjuvant treatments (chemotherapy, radiotherapy).
(Copyright © 2011 Elsevier España, S.L. y SEMNIM. All rights reserved.)
Databáze: MEDLINE