Extracapsular Invasion of Sentinel Lymph Nodes Is Not Associated With Disease Recurrence in Breast Cancer

Abstract

The purpose of this study was to evaluate the presence of extracapsular invasion (ECI) in positive sentinel lymph nodes (SLNs) as a predictor of disease recurrence in breast cancer. SLN biopsy was performed on 318 breasts of 316 breast cancer patients, of which 50 (15.7%) had positive SLNs. Six (12.0%) of these 50 cases had disease recurrence. The clinicopathologic features of these cases were reviewed. The ECI at SLNs was not significantly associated with disease recurrence. The recurrence-free interval by Kaplan-Meier curves did not differ significantly among patients with and without ECI at SLNs. On the other hand, metastasis at non-SLNs was observed in 12 cases (24.0%) among the 50 cases with positive SLNs, and in the non-SLN metastasis group there were 7 patients with ECI at non-SLNs. Three of 7 cases with ECI at non-SLNs had disease recurrence and none of those 5 without ECI at non-SLNs had disease recurrence. Our current study suggests that the presence of ECI at metastatic SLNs is not associated with recurrent disease in breast cancer. Our results also imply that patients with ECI at positive non-SLNs have a high risk of disease recurrence.

Extra-nodal extension of sentinel lymph node metastasis is a marker of poor prognosis in breast cancer patients: A systematic review and an exploratory meta-analysis

“…After excluding 160 articles based on title/abstract review, 12 articles were retrieved for full text review and, following the application of the inclusion criteria (exclusion of 7 studies: doubled cohort = 1 study, no data on SLN = 3 studies, reviews = 2 studies, no control group = 1 study), 5 unique articles resulted as eligible for this meta-analysis [20][21][22][23][24] (Supplementary Figure 1).…”

“…The studies were conducted in Europe (2 studies) [21,24], Asia (2 studies) [22,23] and North America (1 study) [20]. Altogether, 624 patients (163 ENE+ and 461 ENE-)…”

“…as the extension of metastatic cells through the nodal capsule into the perinodal adipose tissue [20,21,23,24]. The study by Fujii et al [22] considered ENE as the extra-capsular growth of tumor cells, the invasion of perinodal fat or the extranodal location of tumor cells, extending in this way the classic definition. Using this definition, also free tumor deposits in the adipose tissue surrounding the SLN could be included in our meta-analysis, introducing a possible bias.…”

Extranodal Extension Predicts Poor Survival Outcomes among Patients with Bladder Cancer

“…The detection of ENE may be influenced by observers, leading to a significant interobserver variability. A study by Fujii et al considered ENE as the extracapsular growth of tumor cells, invasion of perinodal fat, or extranodal location of tumor cells [22]. Because of the emerging clinical significance of ENE, adopting a standard definition is important.…”

Breast Cancer in Nepal: Current status and future directions (Review)

“…Alike Indian populations, few Nepalese patients are offered post-mastectomy reconstruction, and only a small proportion of those offered accept to have it performed, probably due to the reconstructive procedure being seen as an unnecessary financial burden (7,30). The presence of axillary lymph node involvement is among the most important prognostic factors in breast cancer patients (32). Surgical staging of breast cancer by axillary lymph node dissection remains to be frequently practiced by many hospitals in Nepal (19); however, axillary lymph node dissection is increasingly being replaced by the sentinel node procedure, and sentinel node biopsy is now regarded as the standard procedure for axillary staging of breast cancer (33).…”