Breast Cancer Survival in Relation to the Metastatic Tumor Burden in Axillary Lymph Nodes

Abstract

This study demonstrates a worse prognosis for patients with micrometastases than for node-negative patients.

Sentinel lymph node analysis in breast cancer: contribution of one-step nucleic acid amplification (OSNA)

“…In these 19 patients, metastasis quantification was impossible because of interference in the molecular reaction. This absence of SLN quantification can be a real problem, as illustrated in recent studies demonstrating the controversial meaning of micrometastasis [18,19]. The mechanisms of interference which generate inhibition are unknown; an evaluation is ongoing.…”

99mTc-Tilmanocept: A Novel Molecular Agent for Lymphatic Mapping and Sentinel Lymph Node Localization

“…Nodal involvement has a significant impact on tumor staging, treatment, and prognosis. However, in breast cancer, most studies show no change in survival or only a slightly reduced survival in patients with nodal micrometastasis compared with those without (2)(3)(4). Thus, lymphatic mapping and SLN localization have emerged as accurate and minimally invasive procedures for identifying clinically node-negative patients.…”

Lymph node ratio, number of excised nodes and sentinel-node concepts in breast cancer

“…Previously, we have shown in the Dutch MIRROR study that isolated tumor cells and micrometastases as final nodal status are significantly associated with increased risk of disease-events at a hazard ratio of about 1.5 as compared with patients having node-negative disease [10]. Some other SN studies could [11,12] but some could not confirm this association between micrometastatic disease and clinical outcome [13][14][15]. However, it is noted that the MIRROR study is by far the largest SN study on prognostic relevance of isolated tumor cells and micrometatases, with outcome being assessed in patients who had not received systemic therapy and SN classification on full central pathology revision, and by such offering the most robust data on this issue.…”

“…At present SN biopsy can be considered to be an effective procedure in the assessment of regional nodal status in clinically N0 cancer patients, and LNR considered to be the most effective prognostic factor that assesses the extent of therapeutic nodal dissection in node-positive tumors [15].In breast cancer the concept of LNR cannot be consistent with the concept of SN biopsy if completion ALND is considered unnecessary in SN-positive patients, and if staging by SN biopsy is considered to be the only necessary surgical treatment for these patients.…”