The role of micrometastatic disease in sentinel lymph node in breast cancer.
Sentinel lymph node (SLN) biopsy is the standard procedure for axillary node staging in breast cancer. Improvements in histopathological analysis and immunohistochemistry have recently increased the rate of detection of lymph nodal micrometastases. The clinical implications and prognostic significance of micrometastases in SLN still remain a controversial issue. Literature review was analyzed by searches of Medline and PubMed data bases. Whereas most studies carried on small groups of patients did not show differences in survival, recently some studies with longer follow-up and with larger populations demonstrated that prognosis of patients with micrometastases is worse compared to that of patients with SLN free of disease. To date, completion axillary dissection remains the standard option when a macro or micrometastasis (0.2-2 mm) in the SLN is found. However, in absence of level-1 evidence guidelines, each case requires discussion in the context of a multi-disciplinary team.
Department of Surgical Sciences, University of Insubria, Varese, Italy. francesca.rovera@uninsubria.it
Francesca
F
Rovera
Francesco
F
Frattini
Corrado
C
Chiappa
Cristiano
C
Piscopo
Veronica
V
Bianchi
Gianlorenzo
G
Dionigi
Stefano
S
Rausei
Luigi
L
Boni
Renzo
R
Dionigi
D001365:Axilla / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D021701:Sentinel Lymph Node Biopsy