Prevalence of Micrometastases and Isolated Tumor Cells in the Sentinel Node in Early Stage Breast Cancer

Abstract

AimTo analyze the prevalence of isolated tumor cells (ITC) and micrometastases in the sentinel lymph node of early stage breast cancer. Material and methodsA total of 234 patients diagnosed of breast cancer, stage 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 at surgery. 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 to 71 months. ResultsITC 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. ConclusionsITC and micrometastases were found in the sentinel lymph 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).