Predicting the probability of additional nodal metastases in breast cancer patients with positive sentinel node biopsy (CROSBI ID 522768)
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Matušan, Koviljka ; Mustać, Elvira ; Marijić, Blažen ; Kolić, Ivana ; Jonjić, Nives
engleski
Predicting the probability of additional nodal metastases in breast cancer patients with positive sentinel node biopsy
Axillary lymph node dissection (ALND) is an important procedure in the staging of breast cancer patients. However, it is associated with significant morbidity rate. In addition, using early diagnosis a high number of cases with negative lymph nodes can be identified. The lymph node, defined as “ sentinel lymph node” (SLN), would be the first to receive tumoral drainage. Less morbid but accurate staging procedure using mapping and SLN biopsy has been introduced. The aim of this study was to estimate the likelihood of additional disease in the axilla after SLN analysis. Breast carcinomas from 259 patients and SLN biopsies followed by ALND were examined. The median age of the patients was 59 years, and approximately 75% were postmenopausal. Tumor size was 1.4± 0.8 cm (almost 80% in pT1). SLN were positive in 59 out of 259 carcinomas (22.8%), 30 (11.6%) with micrometastasis (≤ 2.0 mm) and 29 (11.2%) with metastasis. Tumor size (p=0.004) and presence of lymphovascular invasion (LVI) (p=0.034) were found to be significant predictors of pathologically positive SLN. Following ALND, positive non-SLN were present mostly in patents with metastasis in SLN (p=0.003), in carcinomas with higher nuclear grade (p=0.044), decreased estrogen receptor (p=0.042) and progesterone receptor (p=0.042) status. Finally, lymph node status (pN) following SLN biopsy and ALND was found to be significantly associated with tumor size (p=0.006), LVI (p=0.037), PR status (p=0.023) and Her-2 status (p<0.001). These results confirm that detail analysis of the primary tumor and SLN may increase the precision selection of patients for further axillary surgery or radiation therapy.
axillary metastases; breast cancer; prediction; sentinel
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21st International Meeting of Adriatic Society of Pathology
poster
24.06.2006-25.06.2006
Trst, Italija