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Erschienen in:
01.04.2012 | Breast Oncology
Clinical Implications of Occult Metastases and Isolated Tumor Cells in Sentinel and Non-Sentinel Lymph Nodes in Early Breast Cancer Patients: Serial Step Section Analysis with Long-Term Follow-Up
Erschienen in: Annals of Surgical Oncology | Ausgabe 4/2012
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Background
This study was designed to clarify retrospectively the clinical significance of occult metastases in both sentinel lymph nodes (SLNs) and non-SLNs in patients with early breast cancer.
Methods
A total of 109 (80.1%) of 136 women with breast cancer who had consecutively undergone SLN biopsy (176 lymph nodes) were intraoperatively diagnosed as being free of SLN involvement. SLNs were routinely examined by hematoxylin–eosin (HE) staining of one to four frozen sections per node. Sixty-four (58.7%) of these patients also underwent backup axillary dissection. For the 109 patients, all formalin-fixed, paraffin-embedded tissues of SLNs and non-SLNs were entirely cut into 5-μm-thick sections. All serial step sections at 85-μm intervals were stained with HE and immunohistochemistry with pancytokeratin.
Results
Occult metastases in SLNs and non-SLNs were detected in 25 (23%) and 10 (16%) patients, respectively. The presence of occult SLN metastasis was marginally correlated with T-factor (P = 0.06), and predictive factors for occult non-SLN metastases were tumor nuclear grade (P = 0.039). With a median follow-up of 86 months, disease-free survival (P = 0.3) or overall survival (P = 0.8) did not differ between the patients with and without occult SLN metastases, regardless of backup axillary lymph node dissection.
Conclusions
SLN or non-SLN occult metastases detected by serial step sections at 85-μm intervals did not have significant prognostic implications.