The impact of nodal isolated tumor cells on survival of breast cancer patients

Herbert, Garth S.; Sohn, Vance Y.; Brown, Tommy A.

doi:10.1016/j.amjsurg.2007.01.007

Cited by 26 publications

(16 citation statements)

References 18 publications

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“…On the other hand, no axillary recurrences were found in the SN ITC-positive patients where ALND had not been performed. This is in keeping with observations from other investigators [5,6] and might suggest a more conservative approach in at least sub-groups of patients. Others have looked into this [7] but were not able to identify a subset of patients where the risk of non-SN metastases was less than 5%.…”

Section: Discussionsupporting

confidence: 75%

Sentinel node biopsy in breast cancer: Five years experience from Denmark

et al. 2008

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Section: Discussionsupporting

confidence: 75%

Sentinel node biopsy in breast cancer: Five years experience from Denmark

et al. 2008

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“…A number of studies have re-evaluated the lymph nodes of breast cancer patients that were considered negative by initial routine histological assessment using hematoxylin and eosin (H&E) staining [5][6][7][8][9][10][11][12][13][14]. They found that 9-32% of previously node-negative cases had occult tumor cell deposits after review, using various methods such as serial sectioning and/or immunohistochemical (IHC) staining [5].…”

Section: Introductionmentioning

confidence: 98%

The prognostic impact of occult nodal metastasis in early breast carcinoma

Park

Kåresen

Naume

et al. 2009

Breast Cancer Res Treat

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The clinical relevance of isolated tumor cell (ITC: 0.2-2.0 mm) in axillary lymph nodes (ALNs) remains unknown. The aim of this study was to determine their prognostic significance. A total of 295 patients considered as pN0 after routine histological assessment, were reevaluated with ten-level cytokeratin immunohistochemistry (IHC) and two-level hematoxylin-eosin sections. Survival rates, i.e. disease-free survival (DFS), distant disease-free survival (DDFS) and breast cancer specific survival (BCSS) were compared with those of reevaluated node-negative patients. A total of 84 patients (28%) had ITC/MM identified on IHC sections. ITC had no impact on survival at a median 8.2 years of follow-up, whereas MM showed a trend toward poorer DFS (P = 0.091, log rank) and DDFS (P = 0.066) and significantly reduced BCSS (P = 0.016). In multivariate analyses, detection of MM was an independent prognostic factor for DDFS (P = 0.025) and BCSS (P = 0.01) in adjuvant un-treated patients. Micrometastases (MMs) in axillary lymph nodes have prognostic impact. This was not found for ITC. This finding supports the use of systemic adjuvant therapy in patients with MM.

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“…Advances in molecular techniques now make it possible to detect cancer cells at levels below the limit for routine histological examination. The significance of this microscopic disease in the sentinel lymph node is not well understood [19,20]. As we improve our ability to identify early spread of cancer, it is likely that more patients may be considered for therapy.…”

Section: Introductionmentioning

confidence: 99%

Promoter hypermethylation in sentinel lymph nodes as a marker for breast cancer recurrence

Carraway

Wang²,

Blackford

et al. 2008

Breast Cancer Res Treat

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Purpose-Promoter methylation of tumor suppressor genes in histologically negative sentinel lymph nodes (HNSN) of early stage breast cancer patients has not been extensively studied. This study evaluates the methylation frequency and pattern in HNSN to determine if detection of hypermethylation of one or more genes is associated with an increased recurrence risk in node negative breast cancer.Experimental design-In 1998, a prospective study of patients with early stage breast cancer and HNSN was initiated in order to correlate sentinel node analysis with clinical outcome. Nodal tissue was selected from 120 HNSN patients for methylation analysis in at least one and up to six sentinel nodes using a panel of nine genes. Corresponding primary breast tumors from 79 patients were also evaluated for hypermethylation. Methylation analysis was performed using nested Methylation Sensitive PCR (n-MSP). Logistical regression was used to evaluate the relationship between clinical recurrence and methylation status.Results-Over a median follow-up of 79 months, 13 of the 120 patients had clinical recurrence. Hypermethylation of genes was frequently observed in HNSN, but there was no correlation of methylation pattern and clinical recurrence. However, increased frequency of gene methylation of the primary tumor correlated with clinical recurrence.Conclusions-Although hypermethylation of multiple genes occurs frequently in HNSN of breast cancer patients, it is not associated with breast cancer recurrence in the first 7 years of clinical follow-up.

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The impact of nodal isolated tumor cells on survival of breast cancer patients

Cited by 26 publications

References 18 publications

Sentinel node biopsy in breast cancer: Five years experience from Denmark

Sentinel node biopsy in breast cancer: Five years experience from Denmark

The prognostic impact of occult nodal metastasis in early breast carcinoma

Promoter hypermethylation in sentinel lymph nodes as a marker for breast cancer recurrence

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