title: [Intramammary lymph node sentinel metastasis without metastasis in axilla. Axillary lymph node dissection or conservative surgery?].
abstract: The sentinel lymph node biopsy is a standard treatment for patients with breast cancer and clinically negative axilla lymph node. The presence of an extra-axillary and intra-axillary (IM) sentinel lymph node (SLN) occurs in up to 2.6% of cases. In the presence of a metastatic IM SLN, axillary positivity may occur in up to 81% of cases. Due to the limited number of cases reported, there is no standard treatment for the association of metastatic SLN IM and non-metastatic axillary SLN . We add here two cases to the literature, one of them with metastatic disease in the axilla. The use of a nomogram demonstrated that the risk of axillary metastasis was less than 10% and the addition of these cases to the literature showed that in this situation the rate of axillary metastasis is 6.25%. We discuss the pros and cons of further axillary dissection in this situation.
authors.affiliation: Departamento de Mastologia e Reconstrução Mamária do Núcleo de Mastologia, Hospital de Câncer de Barretos, Fundação Pio XII, Barretos, SP, Brasil.
authors.forename: René Aloisio da Costa
authors.initials: RA
authors.lastname: Vieira
authors.forename: Dionísio Nepomuceno
authors.initials: DN
authors.lastname: Viviani
authors.forename: Suellen Strada
authors.initials: SS
authors.lastname: Ferreira
authors.forename: Antônio
authors.initials: A
authors.lastname: Bailão
authors.forename: Ligia Maria
authors.initials: LM
authors.lastname: Kerr
authors.forename: Angelo Gustavo Zucca
authors.initials: AG
authors.lastname: Matthes
authors.forename: Sonia Marta
authors.initials: SM
authors.lastname: Moriguchi
mesh_terms: D000328:Adult; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy