title: Sentinel lymph node biopsy in women with pT1a or "microinvasive" breast cancer.
abstract: The role of sentinel lymph node biopsy (SLNB) in pT1a and "microinvasive" breast cancer has not been extensively studied. We report our experience with SLNB in patients with "minimal" breast cancer to determine the incidence and type of SLN metastases, and to study the potential impact on their surgical or oncological management. Among some 3387 women operated upon for primary breast cancer who underwent sentinel lymph node biopsy at nine institutions participating in the Rome Breast Cancer Study Group, 251 were staged pT1a or pT1mic (7.4%). There were 13 cases of sentinel lymph node metastases identified in this group of patients (5.2%), seven macrometastases and six micrometastases. Additionally, ITC were diagnosed by immunohistochemistry in four cases (1.6%). The incidence of SLN metastases was 7/174 (4%) and 6/77 (7.8%) in patients with pT1a and pT1mic tumors, respectively (p=0.2). Age and histological grade were predictive factors for SLN metastases. Chemotherapy was seldom directed by axillary node status (8/38 patients). As the incidence of SLN metastases in these patients is very small, particularly in the pT1a group, the indications for even a minimally invasive procedure, such as sentinel lymph node biopsy, should be probably individualized.
authors.affiliation: Department of Surgery, San Giovanni-Addolorata Hospital, Via Amba Aradam 4, 00184 Rome, Italy. lfortunato@tiscali.it
authors.forename: Lucio
authors.initials: L
authors.lastname: Fortunato
authors.forename: Marcello
authors.initials: M
authors.lastname: Santoni
authors.forename: Stefano
authors.initials: S
authors.lastname: Drago
authors.forename: Giacomo
authors.initials: G
authors.lastname: Gucciardo
authors.forename: Massimo
authors.initials: M
authors.lastname: Farina
authors.forename: Claudio
authors.initials: C
authors.lastname: Cesarini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cabassi
authors.forename: Claudio
authors.initials: C
authors.lastname: Tirelli
authors.forename: Daniela
authors.initials: D
authors.lastname: Terribile
authors.forename: Gian Battista
authors.initials: GB
authors.lastname: Grassi
authors.forename: Smeralda
authors.initials: S
authors.lastname: De Fazio
authors.forename: Carlo Eugenio
authors.initials: CE
authors.lastname: Vitelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy
chemical_list: D000970:Antineoplastic Agents