Micrometastases or Isolated Tumor Cells and the Outcome of Breast Cancer

Boer, Maaike de; Deurzen, Carolien H.M. van; Dijck, J.A.A.M. van; Borm, George F.; Diest, Paul J. van; Adang, Eddy; Nortier, J.W.R.; Rutgers, Emiel J. T.; Seynaeve, C.; Menke-Pluymers, Marian B. E.; Bult, Peter; Tjan‐Heijnen, Vivianne C. G.

doi:10.1056/nejmoa0904832

Cited by 464 publications

(308 citation statements)

References 22 publications

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“…In this study, 33.33% of the animals diagnosed with ITC had more aggressive tumors, such as carcinosarcoma and solid carcinoma. Such behavior may be similar to that observed in women with breast cancer, in whom the clinical relevance of identifying cell clusters <0.2 mm has shown conflicting results and may be directly related to the histologic type studied 13, 16, 18, 21…”

Section: Discussionmentioning

confidence: 56%

“…Higher rates of recurrence and death are observed in women with micrometastases compared with women with negative lymph nodes; these assessments, coupled with quantification of metastatic burden, are a clinically relevant predictor of non‐SLN metastasis 8, 9, 10, 11, 12, 13. This type of assessment, however, has been the subject of great debate, because there are no differences in prognosis between women with micrometastases and those with ITC 14, 15, 16, 17, 18, 19, 20, 21…”

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confidence: 99%

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Quantitation of the Regional Lymph Node Metastatic Burden and Prognosis in Malignant Mammary Tumors of Dogs

Araújo

Campos

Ferreira

et al. 2015

Veterinary Internal Medicne

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BackgroundAs in women, regional lymph node status impacts survival in dogs with malignant mammary tumors. However, few studies have evaluated regional lymph node metastases in dogs with malignant mammary gland tumors.ObjectivesTo estimate overall survival based on the assessments of the lymph node status and the morphologic and morphometric features in female dogs with malignant mammary gland tumors.Materials and MethodsIn total, 178 lymph nodes from 97 female dogs were assessed and reviewed, and after confirmation by immunohistochemistry (IHC), 161 lymph nodes were selected for analysis of metastases. Animals were considered metastasis‐free (negative lymph nodes) only after IHC analysis for cytokeratin AE1/AE3. The number of positive lymph nodes, the number of metastatic foci, the maximum diameter and the area of metastasis were analyzed, and estimates of overall survival were made.ResultsDogs with metastasis had lower mean survival than those with metastasis‐free regional lymph nodes, showing a direct relationship between the number of affected lymph nodes and shorter survival. However, histologic analysis of the lymph nodes identified lower survival rates in animals with macrometastases and isolated tumor cells, areas of metastasis >20.11 mm², and metastatic diameters >7.32 mm.ConclusionThe identification of ≥1 lymph nodes positive for metastasis and morphometric characterization of lymphatic metastases indicate the prognostic relevance of lymph nodes status in dogs with mammary tumors.

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Section: Discussionmentioning

confidence: 56%

mentioning

confidence: 99%

Quantitation of the Regional Lymph Node Metastatic Burden and Prognosis in Malignant Mammary Tumors of Dogs

Araújo

Campos

Ferreira

et al. 2015

Veterinary Internal Medicne

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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. In contrast, because the OSNA assay can evaluate a whole lymph node in a standardized manner, follow-up of the OSNA cohort can reveal the clinical impact of sentinel lymph node micrometastasis.…”

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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“…Some studies have attempted to explore the factors affecting the results of SLN biopsy. Body mass index (BMI), tumor location and also histologic grade of the tumor are supposed to be risk factors which decrease predictive value of negative SLN biopsy (de Boer 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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Micrometastases or Isolated Tumor Cells and the Outcome of Breast Cancer

Cited by 464 publications

References 22 publications

Quantitation of the Regional Lymph Node Metastatic Burden and Prognosis in Malignant Mammary Tumors of Dogs

Quantitation of the Regional Lymph Node Metastatic Burden and Prognosis in Malignant Mammary Tumors of Dogs

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

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