title: [Prevalence of micrometastases and isolated tumor cells in the sentinel node at early stage breast cancer].
abstract: OBJECTIVE
  To analyze the prevalence of isolated tumor cells (ITC) and micrometastases in the sentinel node of early stage breast cancer.
  
  
  METHODS
  A total of 234 patients diagnosed of breast cancer, stages T1 or T2, with no axillary involvement detected by palpation or ultrasound-FNA, were studied. The sentinel node (SN) was identified by lymphoscintigraphy and removed in the operating room. Serial sections and immunohistochemical staining were then performed, classifying them as negative (SN-), negative with ITC (SN-ITC), positive with micrometastases (SN+mic) and positive with macrometastases (SN+mac). A complete axillary lymphadenectomy (CAL) was carried out in those cases with micro- or macrometastases, the former being classified as negative (CAL-), positive with micrometatases (CAL+mic), and positive with macrometastases (CAL+mac). The follow-up ranged from 6-71 months.
  
  
  RESULTS
  ITC were found in 12 patients (5.1%) and micrometastases in 24 (10.3%). Thus, a total of 36 patients were affected by some of these conditions (15.4%). In the group with micrometastases, the result of CAL was CAL- in 19/24 (79.1%), CAL+mic in 2 (8.3%) and CAL+mac in 3 (12.5%). No axillary recurrences have occurred up to date.
  
  
  CONCLUSIONS
  ITC and micrometastases were found in the sentinel node in a significant percentage of patients in the early stages of breast cancer. The low percentage of further axillary invasion in the group of micrometastases may open up the possibility of avoiding CAL in favor of other adjuvant treatments (chemotherapy, radiotherapy).
authors.affiliation: Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, España. jmcordero@sescam.jccm.es
authors.forename: J M
authors.initials: JM
authors.lastname: Cordero García
authors.forename: A
authors.initials: A
authors.lastname: Palomar Muñoz
authors.forename: M
authors.initials: M
authors.lastname: Delgado Portela
authors.forename: A M
authors.initials: AM
authors.lastname: García Vicente
authors.forename: J P
authors.initials: JP
authors.lastname: Pilkington Woll
authors.forename: V M
authors.initials: VM
authors.lastname: Poblete García
authors.forename: M E
authors.initials: ME
authors.lastname: Bellón Guardia
authors.forename: R
authors.initials: R
authors.lastname: Pardo García
authors.forename: L
authors.initials: L
authors.lastname: Rabadán Ruiz
authors.forename: A
authors.initials: A
authors.lastname: Soriano Castrejón
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology / Q000556:secondary* / Q000628:therapy; D018275:Carcinoma, Lobular / Q000453:epidemiology / Q000556:secondary / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D061206:Neoplasm Micrometastasis / Q000175:diagnosis / Q000473:pathology*; D009367:Neoplasm Staging; D010173:Palpation; D015995:Prevalence; D015641:Radiography, Interventional; D011877:Radionuclide Imaging; D018714:Radiotherapy, Adjuvant; D021701:Sentinel Lymph Node Biopsy; D018084:Ultrasonography, Interventional; D019564:Unnecessary Procedures