title: Prognostic value of isolated tumor cells and micrometastases of lymph nodes in early-stage breast cancer: a French sentinel node multicenter cohort study.
abstract: To define the prognostic value of isolated tumor cells (ITC), micrometastases (pN1mi) and macrometastases in early stage breast cancer (ESBC). We conducted a retrospective multicenter cohort study at 13 French sites. All the eligible patients who underwent SLNB from January 1999 to December 2008 were identified, and appropriate data were extracted from medical records and analyzed. Among 8001 patients, including 70% node-negative (n = 5588), 4% ITC (n = 305), 10% pN1mi (n = 794) and 16% macrometastases (n = 1314) with a median follow-up of 61.3 months, overall survival (OS) and recurrence-free survival (RFS) rates at 84 months were not statistically different in ITC or pN1mi compared to tumor-free nodes. Axillary recurrence (AR) was significantly more frequent in ITC (1.7%) and pN1mi (1.5%) compared to negative nodes (0.6%). Survival and AR rates of single macrometastases were not different from those of ITC or pN1mi. In case of 2 macrometastases or more, survival rates decreased and recurrence rates increased significantly. Micrometastases and ITC do not have a negative prognostic value. Single macrometastases might have an intermediate prognostic value while 2 macrometastases or more are associated with poorer prognosis.
authors.affiliation: Institut Paoli Calmettes and CRCM, 232 Bd Sainte Marguerite, Marseille, France; Aix Marseille Université, France. Electronic address: g.houvenaeghel@orange.fr.
authors.forename: Gilles
authors.initials: G
authors.lastname: Houvenaeghel
authors.affiliation: Institut René Gauducheau, Site hospitalier Nord, St Herblain, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Classe
authors.affiliation: Institut Gustave Roussy, 114 rue Edouard Vaillant, Villejuif, France.
authors.forename: Jean-Rémy
authors.initials: JR
authors.lastname: Garbay
authors.affiliation: Centre Oscar Lambret, 3 rue Frédéric Combenal, Lille, France.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Giard
authors.affiliation: Institut Paoli Calmettes and CRCM, 232 Bd Sainte Marguerite, Marseille, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Cohen
authors.affiliation: Centre Léon Bérard, 28 rue Laennec, Lyon, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Faure
authors.affiliation: Centre Claudius Regaud, 20-24 rue du Pont St Pierre, Toulouse, France.
authors.forename: Charytensky
authors.initials: C
authors.lastname: Hélène
authors.affiliation: Centre René Huguenin, 35 rue Dailly, Saint Cloud, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Belichard
authors.affiliation: Hôpital Tenon, 4 rue de la Chine, Paris, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Uzan
authors.affiliation: Centre Georges François Leclerc, 1 rue du Professeur Marion, Dijon, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Hudry
authors.affiliation: Hôpital de Grasse, Chemin de Clavary, Grasse, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Azuar
authors.affiliation: Hôpital des Diaconnesses, 18 rue du Sergent Bauchat, Paris, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Villet
authors.affiliation: Centre Jean Perrin, 58 rue Montalembert, Clermont Ferrand, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Penault Llorca
authors.affiliation: Institut Bergonié, 229 Cours de l'Argonne, Bordeaux, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Tunon de Lara
authors.affiliation: Institut Paoli Calmettes and CRCM, 232 Bd Sainte Marguerite, Marseille, France; Aix Marseille Université, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Goncalves
authors.affiliation: Biostatistic, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Esterni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D061206:Neoplasm Micrometastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D016019:Survival Analysis
keywords: Breast cancer; Isolated tumor cells; Micrometastases; Prognosis; Sentinel lymph node biopsy