title: The prognostic value of sentinel lymph node micrometastases in patients with invasive breast carcinoma.
abstract: OBJECTIVE
  The prognostic value of sentinel lymph node micrometastases in invasive breast cancer patients is still widely debated. Even if, in the absence of unequivocal guidelines, the axillary lynphadenectomy is not still performed in the routine clinical care of these patients.
  
  
  METHODS
  We have retrospectively analyzed 746 patients with operable invasive breast cancer and clinically negative axillary lymph nodes. These patients underwent conservative surgery or total mastectomy with sentinel lymph node biopsy. Patients with micrometastases in the sentinel lymph node treated with axillary dissection has been checked and the involvement of the remaining lymph nodes analyzed. Patients with micrometastases in the SLN not followed by axillary dissection have been checked as well and the incidence of recurrences has been evaluated in both groups.
  
  
  RESULTS
  Micrometastases were found in 51 (6.83%) patients and isolated tumor cells in 8 (1.07%) patients at frozen section and confirmed at the final hystopathologic examination. Fifteen of these patients underwent complete axillary dissection: two of them (13.33%) had metastatic involvement of other axillary lymph nodes. The other 44 patients didn't receive further surgical axillary procedure. No axillary recurrences in these patients were found during a median follow up of 65.3±9.65 months (range 42-78 months).
  
  
  CONCLUSIONS
  Based on the results and according to some recent randomized trials we can say that axillary lynphadenectomy can be avoided when micrometastases are found in sentinel lynph nodes. It should be performed anyway, depending on the analysis of the biomedical profile of the tumor.
  
  
  BACKGROUND
  Breast carcinoma, Micrometases, Sentinel lymph node.
authors.forename: Calogero
authors.initials: C
authors.lastname: Cipolla
authors.forename: Giuseppa
authors.initials: G
authors.lastname: Graceffa
authors.forename: Roberta
authors.initials: R
authors.lastname: La Mendola
authors.forename: Salvatore
authors.initials: S
authors.lastname: Fricano
authors.forename: Martina
authors.initials: M
authors.lastname: Fricano
authors.forename: Salvatore
authors.initials: S
authors.lastname: Vieni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D061206:Neoplasm Micrometastasis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D009376:Neoplasms, Hormone-Dependent / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery / Q000628:therapy; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy / Q000706:statistics & numerical data*; D013668:Technetium Tc 99m Aggregated Albumin
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin