How researchers vary in opinion. Note what is stated below on this topic. I had this bookmarked from the SABC 2005:[img]file:///C:/DOCUME%7E1/HP_OWNER/LOCALS%7E1/TEMP/moz-screenshot.jpg[/img][img]file:///C:/DOCUME%7E1/HP_OWNER/LOCALS%7E1/TEMP/moz-screenshot-1.jpg[/img][img]file:///C:/DOCUME%7E1/HP_OWNER/LOCALS%7E1/TEMP/moz-screenshot-2.jpg[/img][img]file:///C:/DOCUME%7E1/HP_OWNER/LOCALS%7E1/TEMP/moz-screenshot-3.jpg[/img][img]file:///C:/DOCUME%7E1/HP_OWNER/LOCALS%7E1/TEMP/moz-screenshot-4.jpg[/img]
Significance of sentinel lymph node micrometastasis on survival for patients with invasive breast cancer.
Cox C, Vrcel V, Riker A, White L, Allred N, Ramos D, Myers M, Dupont E, King J, Cantor A, Diaz N. H. Lee Moffitt Cancer Center, Tampa, FL
OBJECTIVE: The overall objective of this study was to test the impact of micrometastatic carcinoma detected by sentinel lymph node (SLN) biopsy on survival in invasive breast cancer patients. To do so, we compared survival outcomes in such patients with a negative SLN biopsy and the outcomes of those with micrometastatic disease in a SLN.
METHODS: The charts of 2145 invasive breast cancer patients with pathology reports of SLN with either micrometastatic or no metastatic disease were reviewed. The SLN H
E and immunostained (cytokeratin) slides of patients with the diagnosis of micrometastatic carcinoma were analyzed and reclassified according to the 6th edition of the AJCC Cancer Staging Manual. Tumor deposits > 0.2 mm but not > 2 mm were classified as N1mi. Patients with SLNs with isolated tumor cells not > 0.2 mm were classified as N0(i+). SLNs with no epithelial cells on either H
E or immunostaining were classified as N0(i-). Kaplan Meier graphs of overall survival (OS) and disease free survival (DFS) were done.
RESULTS: Of the 2145 patients reviewed, 1854 (87%) were N0(i-). 291(13%) of our patients had single cells and/or small cell clusters or micrometastatic disease. 138 (6%) were reclassified as N1mi and 153 (7%) as N0(i+). OS and DFS of the patients with N1mi SLN differed significantly from patients with N0(i-) SLN (p=0.005 and 0.016 respectively; Figures 1 and 2).
CONCLUSIONS: The detection of micrometastatic carcinoma in the SLNs of invasive breast cancer patients, as presently defined by the AJCC, is a significant indicator of survival. Subset analysis of N0(i+) patients will be presented. Results of the ACOSOG Z0010 trial may validate the latter results and clarify the clinical significance of N0(i+) detected by SLN biopsy.