title: Prognosis and treatment of micrometastatic breast cancer sentinel lymph node: a population-based study.
abstract: OBJECTIVE
  Major concern of sentinel lymph node (SLN) biopsy (SLNB) regards the prognosis of micrometastasis (Nmic) in SLN. The purpose of this study is to determine the adequate surgical treatment and prognosis of Nmic in a population-based series of breast cancer patients.
  
  
  METHODS
  All non-metastatic breast cancer patients registered by the Modena Cancer Registry (MCR), from January 2000 to December 2008, were evaluated for SLNB. Information on patients' characteristics, treatment and follow-up was collected.
  
  
  RESULTS
  Among 2,078 patients treated with SLNB, 28.5% (590) showed a positive SLN, subdivided in N0i+ 6.3% (31), Nmic 28.8% (176), N1 64.1% (378), and N2 0.8% (5). Of 176 Nmic, 80% (142) received an axillary lymph node dissection (ALND). Only three patients had ≥ 4 SLN involved. No axillary recurrence occurred in Nmic patients. The overall and disease-free survival rates were N0 99.2% and 97.7%, N0i+ 100% and 100%, Nmic 96% and 93.2%, N+ (N1 + N2) 96.1% and 92.4%, respectively (N0 vs. Nmic P<0.001).
  
  
  CONCLUSIONS
  This study suggests that patients with Nmic have a similar prognosis to N+ (N1 + N2) patients, and a low risk of local recurrence, questioning the necessity of ALND for Nmic SLN.
authors.affiliation: Department of Oncology and Haematology, University of Modena and Reggio Emilia, Modena, Italy. hbc@unimore.it
authors.forename: Laura
authors.initials: L
authors.lastname: Cortesi
authors.forename: Manuela
authors.initials: M
authors.lastname: Proietto
authors.forename: Claudia
authors.initials: C
authors.lastname: Cirilli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tazzioli
authors.forename: Alessia
authors.initials: A
authors.lastname: Andreotti
authors.forename: Massimo
authors.initials: M
authors.lastname: Federico
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D061206:Neoplasm Micrometastasis; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy