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Published on: June 1, 2019
The role of axillary lymph node dissection in breast cancer patients with sentinel lymph node micrometastases
M Gipponi1, G Canavese, R Lionetto
1U.O. Patologia Chirurgica Gastroenterologica, Azienda Ospedaliera Universitaria, Osp. San Martino, L.go R. Benzi, 10, 16132 Genoa, Italy. marco.gipponi@unige.it
Aim:
To identify by means of clinical and histopathological features a subset of breast cancer patients with sentinel lymph-node (sN) micrometastases and metastatic disease confined only to the sN in order to spare them an unnecessary axillary lymph node dissection (ALND).
Materials And Methods:
From January 1998 to December 2004, 116 patients with sN micrometastases underwent standard ALND for early-stage (T1-2 N0 M0) invasive breast cancer; clinical and histopathologic parameters were prospectively collected and evaluated by means of univariate and logistic regression analysis in order to identify which patients with sN micrometastases were free of metastasis in axillary non-sN.
Results:
Sixteen of 116 patients with sN micrometastases had tumour involvement of non-sN, with six and 10 patients having non-sN micrometastases and macrometastases, respectively. None of 19 patients with primary tumour measuring
Conclusions:
In patients with sN micrometastases, primary tumour size and lymphovascular invasion significantly predict non-sN status; notably, no patient with T1a-T1b and/or G1 tumours had non-sN metastases so that they could be spared an unnecessary ALND.
