title: The clinical significance of axillary lymph node micrometastases in breast cancer.
abstract: OBJECTIVE
  To evaluate the clinical significancer of axillary lymph-node micrometastases, in the era of sentinel lymph node (SLN) biopsy.
  
  
  METHODS
  Searches of MEDLINE (1966-2003) and an extensive manual review of journals were performed using the key search terms breast cancer, axillary lymph-node micrometastases, micrometastatic disease, and SLN biopsy.
  
  
  METHODS
  All articles identified from the data sources were evaluated and all information deemed relevant was included for this review.
  
  
  CONCLUSIONS
  Axillary lymph-node micrometastases can be detected by serial sectioning, immunohistochemistry, or reverse transcriptase-polymerase chain reaction (RT-PCR). The presence of axillary SLN micrometastases is generally associated with a worse prognosis and is an indication for axillary lymph node dissection (ALND) and adjuvant therapy. The clinical significance of micrometastases identified by RT-PCR remains unknown and further research with longer follow-up is needed to ascertain the clinical implications of a positive result.
authors.affiliation: Department of Surgery, 251 Hellenic Air Force Hospital, Arkadias 19-21, GR-115 26 Athens, Greece. georgesakorafas@yahoo.com
authors.forename: G H
authors.initials: GH
authors.lastname: Sakorafas
authors.forename: J
authors.initials: J
authors.lastname: Geraghty
authors.forename: G
authors.initials: G
authors.lastname: Pavlakis
mesh_terms: D001365:Axilla; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D016019:Survival Analysis