Prognostic impact of macrometastasis linear size in sentinel node biopsy for breast carcinoma

Publication date: Available online 17 May 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Maria P. Foschini, Rossella Miglio, Cecily Quinn, Beatrice Belgio, Peter Regitnig, Simonetta Bianchi, Roberto Nannini, Horst Buerger, Handan Kaya, Ildikó Illyés, Janina Kulka, Clive A. Wells, James De Gaetano, Inta Lipeniece-Karele, Gabor Cserni
The aim of the present study was to evaluate the risk of axillary non-sentinel lymph-node metastases (ALN) in breast cancer patients presenting macrometastasis (Mac-m) in the sentinel lymph node (SN).Materials and MethodsA retrospective series of 1464 breast cancers from patients who underwent ALN dissection following the diagnosis of Mac-m in the sentinel node (SN) was studied. In all the cases the MAC-m linear size was evaluated and correlated with presence or absence of non-SN ALN metastases.ResultsNon-SN metastases were detected in 644\1464 cases (43,98%). The risk of further axillary metastases ranged from 20.2% (37/183) in cases with Mac-m between 2-2.9 mm, to 65.3% (262/401) in cases with Mac-m measuring > 10 mm. The risk of non-SN ALN metastases showed a 3% increase, parallel to each mm increment in SN metastasis size. The data evaluated with the receiver operating characteristic (ROC) curve showed that the Mac-m could be subdivided according to a new cut-off of 7 mm. pT1 tumours, with Mac-m < 7 mm had a risk of non-SN ALN metastases of <30%. Furthermore 109/127 of these (85.8%) had 3 or less non-SN ALN -metastases.ConclusionsThe present data give a detailed description on the risk of non-SN ALN involvement, that may be useful in the evaluation of breast cancer patients. It is suggested that a Mac-m size of < 7 mm is related to a low residual axillary disease burden in breast cancer patients with small (pT1) tumours.



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