Abstract
The concept of the sentinel node describes a primary or sentinel lymph node (SLN), which exists and through which tumour cells from a primary tumour in a particular location must first travel to spread to a particular regional lymph node group. In this series we present three patients presenting with a pathological axillary node associated with either an occult or very small primary breast cancer. In each case the primary tumour was found to have metastasised to the palpable node, however despite the significant enlargement of this node, no other axillary nodes were found to be affected on axillary node clearance. This has led us to postulate that the SLN in some cases contains unique characteristics that enable it to prevent further spread of the tumour up the lymphatic chain. Hence the term the competent sentinel node.
Highlights
The concept of the sentinel node describes a primary or sentinel lymph node (SLN), which exists and through which tumour cells from a primary tumour in a particular location must first travel to spread to a particular regional lymph node group
Recent studies have demonstrated that the sentinel node biopsy (SNB), which utilizes a simple principle, is a reliable and minimally invasive method for determining the status of the regional lymph nodes in patients with clinically node-negative breast cancer [1]
In this series we present three patients presenting with a pathological axillary node associated with either an occult or very small primary breast cancer
Summary
The concept of the sentinel node describes a primary or sentinel lymph node (SLN), which exists and through which tumour cells from a primary tumour in a particular location must first travel to spread to a particular regional lymph node group. Pathological examination revealed only 1/14 axillary nodes showing metastatic carcinoma consistent with a breast primary This node measured 38 mm in greatest dimension (ER 8/8, PgR 8/8, CerbB2 2+). The patient was subsequently treated with chemotherapy, breast irradiation and endocrine therapy This 33-year-old lady presented with a pathological lymph node in the right axilla measuring approximately 3 cm. The patient was subsequently treated with chemotherapy This 48-year-old lady presented with a pathological lymph node in the right axilla measuring approximately 3 cm. Pathological examination revealed only 1/10 axillary nodes showing metastatic carcinoma consistent with a breast primary. This node measured 35 × 25 × 20 mm. Two years later she continues to take tamoxifen and there has been no evidence of recurrence
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