Sentinel lymph nodes with isolated tumour cells and micrometastases in breast cancer: clinical relevance and prognostic significance.
OBJECTIVE
We performed a retrospective review to determine the prognostic significance of isolated tumour cells (ITCs) and micrometastases to the sentinel lymph nodes of patients with breast cancer.


METHODS
A total of 1044 patients with a diagnosis of invasive carcinoma of the breast who underwent surgical treatment including the sentinel lymph node biopsy procedure from July 2004 to October 2009 were included in the study.


RESULTS
In 710 (68%) patients, no metastasis was seen to the sentinel lymph nodes. ITCs were detected in 22 (2.1%) patients, micrometastasis in 52 (5.0%) and macrometastases in 260 (24.9%). With a median follow-up of 28.8 months, disease recurrence was seen in 38 (3.6%) patients and 15 (1.5%) patients died of disease. No disease recurrence or deaths were recorded in women with ITCs in sentinel lymph nodes. In the micrometastasis group, 2 patients suffered disease recurrence and both died of disease.


CONCLUSIONS
We conclude that ITCs in the sentinel lymph nodes did not adversely impact disease free and overall survivals. Although only 2 recurrences with subsequent death occurred in the micrometastasis group, it may suggest a propensity for presence of micrometastases to augur a worse outcome, and justifies continued segregation of ITCs from micrometastasis.
Department of Pathology, Singapore General Hospital, Singapore.
Syed Salahuddin
SS
Ahmed
Aye Aye
AA
Thike
Jabed
J
Iqbal
Wei Sean
WS
Yong
Benita
B
Tan
Preetha
P
Madhukumar
Kong Wee
KW
Ong
Gay Hui
GH
Ho
Chow Yin
CY
Wong
Puay Hoon
PH
Tan
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D061206:Neoplasm Micrometastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
Breast Cancer; Lymph Nodes; Metastasis