European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2006
The prevalence of axillary lymph-node metastases in patients with pure tubular carcinoma of the breast and sentinel node biopsy.
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Leikola J, Heikkilä P, von Smitten K, Leidenius M
Аннотация
AIMS: We aimed to evaluate the prevalence of and the risk factors for axillary lymph-node metastases in pure tubular carcinoma (PTC) of the breast. The role of axillary staging and treatment in PTC was also evaluated.
METHODS: Between March 2001 and August 2004, 33 PTC patients underwent sentinel node (SN) biopsy as a part of their surgical treatment. Level I/II axillary clearance was carried out in case of tumour positive SN findings. To confirm the correct histological diagnosis (PTC, >90% tubular component), the breast tumours were reviewed by an expert breast pathologist.
RESULTS: The SN were successfully harvested in all patients. The median number of SN harvested in the axilla was 3 (range 1-10). Nine (27%) of the 33 patients had axillary nodal metastases. The median number of metastatic nodes was 1 (range 1-3). The median size of the SN metastases was 0.5 mm (mean 1.7 mm, range 0.4-5 mm). In six patients, micrometastases were the only tumour positive SN findings. The median histological tumour size was similar, 9 vs 10mm, in patients with or without axillary metastases. The median patient age was 54 (range 44-71) and 57 (range 39-80) years, respectively. After the histopathological review, six of the 27 patients with true PTC had axillary metastases. The review did not significantly change the risk factors for axillary metastases.
CONCLUSIONS: Every fourth PTC patient has axillary lymph-node metastases, most often micrometastases. SN biopsy appears as a feasible method for axillary staging in PTC patients.
METHODS: Between March 2001 and August 2004, 33 PTC patients underwent sentinel node (SN) biopsy as a part of their surgical treatment. Level I/II axillary clearance was carried out in case of tumour positive SN findings. To confirm the correct histological diagnosis (PTC, >90% tubular component), the breast tumours were reviewed by an expert breast pathologist.
RESULTS: The SN were successfully harvested in all patients. The median number of SN harvested in the axilla was 3 (range 1-10). Nine (27%) of the 33 patients had axillary nodal metastases. The median number of metastatic nodes was 1 (range 1-3). The median size of the SN metastases was 0.5 mm (mean 1.7 mm, range 0.4-5 mm). In six patients, micrometastases were the only tumour positive SN findings. The median histological tumour size was similar, 9 vs 10mm, in patients with or without axillary metastases. The median patient age was 54 (range 44-71) and 57 (range 39-80) years, respectively. After the histopathological review, six of the 27 patients with true PTC had axillary metastases. The review did not significantly change the risk factors for axillary metastases.
CONCLUSIONS: Every fourth PTC patient has axillary lymph-node metastases, most often micrometastases. SN biopsy appears as a feasible method for axillary staging in PTC patients.