Avoiding Axillary Treatment in Sentinel Lymph Node Micrometastases of Breast Cancer: A Prospective Analysis of Axillary or Distant Recurrence

Pernas, Sònia; Gil, Marta; Benítez, A.; Bajén, M.T.; Climent, Fina; Jesús, María; Benito, E.; Gumà, Anna; Gutiérrez, Cristina; Pisa, A.; Urruticoechea, Ander; Pérez, Javier; Gil, Miguel Gil

doi:10.1245/s10434-009-0804-y

Cited by 61 publications

(29 citation statements)

References 22 publications

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“…The risk of further nonsentinel lymph node involvement was reported to be approximately 15% to 20% in patients with sentinel lymph node micrometastasis detected by histological examination [25][26][27][28][29] ; however, it remains controversial whether completion axillary lymph node dissection is needed for patients with sentinel lymph node micrometastasis [30][31][32][33][34] or micrometastasis has a prognostic impact. 2,19,21,35,36 One of the reasons for these controversies is that the conventional histopathological examination is not standardized, and its ability to measure accurate total metastatic volume in a lymph node, particularly for low-volume metastases, is limited.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative molecular assay for sentinel lymph node metastases in early stage breast cancer

Osako

Iwase

Kimura

et al. 2011

Cancer

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BACKGROUND: Conventional histopathological examination is limited in measuring accurate total metastatic volume in a lymph node. Recently, a molecular-based procedure to detect lymph node metastases, one-step nucleic acid amplification (OSNA) assay, has been developed. OSNA assay can assess a whole lymph node and yields semiquantitative results. The authors compared the performance in intraoperative detection of sentinel lymph node metastases with OSNA assay using a whole lymph node versus routine frozen section (FS) histology with a 2 mm-sectioned lymph node. METHODS: Subjects comprised 531 consecutive patients diagnosed with OSNA assay and 618 consecutive patients diagnosed with FS histological examination. The authors compared the sentinel lymph node-positive rate between the OSNA and FS cohorts, and investigated characteristics of patients for whom OSNA could detect metastases but FS could not. OSNA (þ) was defined as micrometastasis, and OSNA (þþ) and (þI) were defined as macrometastasis. RESULTS: OSNA assay detected more cases of sentinel lymph node metastases than FS histology (OSNA 121 of 531, 22.8% vs FS 109 of 618, 17.6%; P ¼ .036), particularly micrometastases (46 of 531, 8.7% vs 28 of 618, 4.5%; P ¼ .0064). There was no difference in macrometastasis detection between OSNA and FS (75 of 531, 14.1% vs 81 of 618, 13.1%; P ¼ .68). OSNA detected more metastases than FS in postmenopausal patients (77 of 302, 25.5% vs 43 of 351, 12.3%; P < .0001), and in tumors without fat invasion (23 of 156, 14.7% vs 6 of 151, 4.0%; P ¼ .012) or lymphovascular invasion (67 of 395, 17.0% vs 45 of 458, 9.8%; P ¼ .042). CONCLUSIONS: Intraoperative OSNA assay detects more sentinel lymph node metastases, particularly micrometastases, than does FS histology. OSNA assay can also detect more metastases in postmenopausal patients or from less aggressive primary tumors compared with FS histology. Cancer 2011;117:4365-

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Section: Discussionmentioning

confidence: 99%

Intraoperative molecular assay for sentinel lymph node metastases in early stage breast cancer

Osako

Iwase

Kimura

et al. 2011

Cancer

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“…Excluding ITC from totally detected metastasis by IHC staining, shows that there is no difference between serial sectioning and IHC staining in metastasis detection. Some other studies suggest that IHC staining can be useful only in particular types of breast cancer such as lobular breast carcinoma (Pernas et al, 2010;Ozcinar et al, 2011). Several studies have also shown the false positive results of IHC staining for metastasis detection (Hansen et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Improved Detection of Metastases by Step Sectioning and Immuno-Histochemical Staining of Axillary Sentinel Nodes in Patients with Breast Carcinoma

Ensani

Enayati²,

Rajabiani³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…The use of this met hod in the SLN bi opsy is very ef fec ti ve to de ter mi ne mini mal me tas ta sis. 11 In six of our ca ses, we de ter mined mic ro me tas ta sis by se ri al sec ti ons and im mu no his toc he mi cal sta i ning. Iso la ted tu mor cells was fo und in two ca ses.…”

Section: Discussionmentioning

confidence: 99%

“…22 ITCs are now ge ne rally be li e ved to be of li mi ted prog nos tic sig ni fi can ce and are ca tego ri zed as no de-ne ga ti ve di se a se and re qu i re no furt her tre at ment. 11 Sin ce the SLN is the most probab le lo ca ti on for the lo cal me tas ta sis, staging can be made more ac cu ra te by detailed investigation of SLN metastasis. The va li da ti on of the SLN biopsy as ac cu ra te sta ging pro ce du re de pends on correct localization of the SLN and sco pe of its his to pat ho lo gi cal examin a ti on.…”

Section: Discussionmentioning

confidence: 99%

Histopathologic Characteristics of Sentinel Lymph Node Biopsy in Breast Carcinoma: Uludağ University Faculty of Medicine Experience

Elezoğlu¹,

Tolunay²,

Taşdelen³

et al. 2011

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : No wa days, sen ti nel lymph no de (SLN) bi opsy is a stan dard ap pro ach giving information abo ut sta tus of the axil lary lymph no des. Se ve ral fac tors af fect me tas ta sis to SLN. In our ca se, we aimed to in dica te his to pat ho lo gi cal pa ra me ters that af fect SLN and non-sen ti nel lymph no de (n-SLN) me tas ta sis, the im portan ce of fro zen sec ti on to de ter mi ne me tas ta sis and im mu no his toc he mistry met hod for his to pat ho lo gi cal exa mi na ti ons. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : In Ulu dag Uni ver sity Fa culty of Me di ci ne, 265 ca ses who had SLN bi op sies we re ret ros pec ti vely exa mi ned. Fro zen sec ti ons, per ma nent sec ti ons and sec ti ons with im mu no his toc he mistry we re fo und out from the arc hi e ve. Then, pre pa ra ti ons we re re-exa mi ned by ex pert pat ho lo gists on bre ast pat hology. R Re e s su ul lt ts s: : The me an age of the ca ses was 53 ye ars. The most frequently ob ser ved tu mor type was in va si ve ductal car ci no ma. Most of the ca ses ha d nuc le ar gra de 2. One hundred ca ses are di ag no sed as ma lig nant. As a re sult of imp le men ta ti on of se ri al sec ti ons and im mu no his toc he mistry to 12 ca ses wit ho ut me tas ta sis, mac ro-me tas tasis in four ca ses, mic ro-me tas ta sis in six ca ses and fi nally iso la ted tu mo ur cells in two ca ses we re de ter mi ned. In pri mary bre ast tu mor, the pre sen ce of ve no us/vas cu lar in va si on (p= 0.021), lympha tic in va si on (p< 0.001), in crea sed pri mary tu mor di a me ter (p= 0.001) and in cre a sed age (p= 0.026) increased SLN me tas ta sis. In pri mary breast tu mor, the pre sen ce of pe ri ne u ral in va si on (p= 0.033) and lympha tic in va si on (p= 0.045), in cre a sed tu mor di a me ter (p= 0.001), and in cre a sed num ber of po si ti ve SLNs (p= 0.015) ca u sed an in cre a se in n-SLN me tas ta sis. C Co on nc c l lu u s si i o on n: : SLN bi opsy is a simp le and re li ab le met hod. In our study, we fo und sta tis ti cally significant re sults bet we en SLN me tas ta sis and age, pri mary tu mor di a me ter, lympha tic in va si on and ve no us/vas cu lar in va si on. Be sides, sta tis ti cally sig ni fi cant re la ti ons hips were fo und bet we en n-SLN me tas ta sis and pri mary tu mor di a me ter, pe ri ne u ral in va si on and lympha tic in va si on as well. In tra o pe ra ti ve analy sis of SLN is very important for sta ging of bre ast car ci no ma and prog no sis. Mo re o ver, ac cu racy of di ag no sis in cre a ses with the app li ca ti ons of se ri al secti on and im mu no his toc he mi cal met hod. K Ke ey y W Wo or rd ds s: : Sen ti nel lymph no de bi opsy; bre ast ne op lasms; pat ho logy Ö ÖZ ZE ET T A Am ma aç ç: : Gü nü müz de sen ti nel lenf no du (SLN) bi yop si si ak sil ler lenf nod la rı nın du ru mu hak kın da bil gi ve ren stan dart bir yak la şım dır. SLN me tas ta zı nı çe şit li fak tör ler et ki ler. Ya zı mız da, SLN ve non sentinel lenf n...

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Avoiding Axillary Treatment in Sentinel Lymph Node Micrometastases of Breast Cancer: A Prospective Analysis of Axillary or Distant Recurrence

Cited by 61 publications

References 22 publications

Intraoperative molecular assay for sentinel lymph node metastases in early stage breast cancer

Intraoperative molecular assay for sentinel lymph node metastases in early stage breast cancer

Improved Detection of Metastases by Step Sectioning and Immuno-Histochemical Staining of Axillary Sentinel Nodes in Patients with Breast Carcinoma

Histopathologic Characteristics of Sentinel Lymph Node Biopsy in Breast Carcinoma: Uludağ University Faculty of Medicine Experience

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