title: [Axillary lymph node dissection in patients with micrometastasis in sentinel lymph node: new predilections].
abstract: OBJECTIVE
  Indication for axillary lymph node dissection (ALND) in patients with breast cancer is recommended in presence of metastasis (>2 mm size) in sentinel lymphnode (LS) or for unidentified LS. Our study's intent proposes new predilections for ALND in presence of micrometastasis (size between 0.2 and 2 mm) in LS since they may not give metastatic involvement in other axillary lymphnodes.
  
  
  METHODS
  In our retrospective study we analyzed 1 119 patients's informations in a period of 7 years (2002/2009): 72 patients resulted positive for micrometastasis in LS. We analyzed cancer histology, size, grading.
  
  
  RESULTS
  Six patients of 72 positive micrometastasis LS were not subjected to ALND. We considered 66 patients: 13 patients were positive for metastasis in other axillary lymphnode; in 9 cases T1c and in 4 cases T2 (TNM classification); in 2 cases lobular infiltrated, in 11 cases ductal infiltrated (histology); in 7 cases were II stage, in 6 cases III stage (grading).
  
  
  CONCLUSIONS
  Nineteen point seven percent of 66 patients with micrometastasis in LS is positive in other axillary lymphnode: this result confirms guide-lines's accuracy, it is not possible to avoid ALND in these patients. It appears that breast cancers responsible for metastasis in other axillary lymphnode have principally a size >1 cm, lobular infiltrated and ductal infiltrated histology and II-III grading.
authors: Dipartimento di Chirurgia I, Azienda Ospedaliero Universitaria, Policlinico di Modena, Modena, Italia. maraysa@hotmail.it
authors: M
authors: M
authors: Bolondi
authors: A
authors: A
authors: Farinetti
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D061206:Neoplasm Micrometastasis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy