title: Non-sentinel lymph node status and prognosis of breast cancer patients with micrometastatic sentinel lymph nodes.
abstract: BACKGROUND
  The prognostic significance of sentinel lymph node (SLN) micrometastases and the need for axillary lymph node dissection (ALND) on patients with micrometastases in SLNs remain controversial.
  
  
  METHODS
  A prospective database of 657 breast cancer patients who underwent SLN biopsy (SLNB) was analyzed. SLNs were detected using a combined method of isosulfan blue dye and small-sized technetium-99m-labeled tin colloid.
  
  
  RESULTS
  Micrometastases in SLNs were found in 50 (7.6%) of 657 patients. Twenty-nine (58.0%) of 50 patients with micrometastatic SLNs underwent ALND and no further metastases were found in non-sentinel lymph nodes. Among 21 patients (42.0%) with micrometastatic SLNs who decided to forego ALND, no axillary lymph node recurrence has been observed during a median follow-up time of 47 months. There is no significant difference in recurrence-free survival between the patients with micrometastatic and negative SLNs (p = 0.90).
  
  
  CONCLUSIONS
  These data suggest that it may not be necessary to perform ALND on patients with micrometastases in SLNs and that the presence of micrometastases in SLNs may not be associated with prognosis.
authors.affiliation: Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Onishi
authors.forename: H
authors.initials: H
authors.lastname: Jinno
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
authors.forename: T
authors.initials: T
authors.lastname: Hayashida
authors.forename: M
authors.initials: M
authors.lastname: Sakata
authors.forename: T
authors.initials: T
authors.lastname: Nakahara
authors.forename: N
authors.initials: N
authors.lastname: Shigematsu
authors.forename: M
authors.initials: M
authors.lastname: Mukai
authors.forename: Y
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000556:secondary / Q000601:surgery; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy