IMPACT OF MICROMETASTASIS AND ISOLATED TUMOR CELLS FOUND ON SENTINEL LYMPH NODES IN EARLY BREAST CANCER
Keywords:
Sentinel Lymph Node Biopsy, Radiotherapy, Breast Cancer, MicrometastasisAbstract
The presence of axillary lymph node metastases is one of the most important prognostic factors in breast cancer and it is often used to guide locoregional and systemic therapy decisions. The question of whether axillary dissection (AD) can be safely omitted in patients with early breast cancer when isolated tumor cells (ITC) or micrometastasis is found in the sentinel node remains a controversial issue in the literature. On the basis of current evidence, AD could probably be safely omitted when micrometastasis or ITC are found. On making this decision, as micrometastasis and ITC are a sign of a biologically different disease, adjuvant radiotherapy and the adjuvant systemic treatment need to be considered.
Downloads
References
Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003;349:546-53. https://doi.org/10.1056/NEJMoa012782
Mansel RE, Fallowfield L, Kissin M, Goyal A, Newcombe RG, Dixon JM, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst. 2006 May 3;98(9):599-609. https://doi.org/10.1093/jnci/djj158
Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Costantino JP, et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. National Surgical Adjuvant Breast and Bowel Project) B32. Lancet Oncol. 2010 Oct;11(10):927-33. https://doi.org/10.1016/S1470-2045(10)70207-2
Viale G, Maiorano E, Mazzarol G, Zurrida S, Galimberti V, Luini A, et al. Histologic detection and clinical implications of micrometastases in axillary sentinel lymph nodes for patients with breast carcinoma. Cancer. 2001;92:1378-84.
Weaver DL. Sentinel lymph nodes and breast carcinoma: which micrometastases are clinically significant? Am J Surg Pathol. 2003 Jun;27(6):842-5.
Bundred NJ, Barnes NL, Rutgers E, Donker M. Is axillary lymph node clearance required in node-positive breast cancer? Nat Rev Clin Oncol. 2015 Jan;12(1):55-61. https://doi.org/10.1038/nrclinonc.2014.188
Nahon S, Brewer Y, Kirscher S, Chauvet B, Berger C, Serin D. Axillary lymph node and bone marrow micrometastases of breast cancer. Bull Cancer. 2001 Nov;88(11):1095-104.
Giuliano AE, Morrow M, Duggal S, Julian TB. Should ACOSOG Z0011 change practice with respect to axillary lymph node dissection for a positive sentinel lymph node biopsy in breast cancer? Clin Exp Metastasis. 2012 Oct;29(7):687-92. https://doi.org/10.1007/s10585-012-9515-z
Lyman GH, Giuliano AE, Somerfield MR, Benson AB 3rd, Bodurka DC, Burstein HJ, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 2005 Oct 20;23(30):7703-20. https://doi.org/10.1200/JCO.2005.08.001
de Boer M, van Deurzen CH, van Dijck JA, Borm GF, van Diest PJ, Adang EM, et al. Micrometastases or isolated tumor cells and the outcome of breast cancer. N Engl J Med. 2009 Aug 13;361(7):653-63. https://doi.org/10.1056/NEJMoa0904832
Youssef MM, Cameron D, Olsen S, Ferguson D. Does axillary lymph node dissection impact survival in patients with breast cancer and isolated tumour cells or micrometastasis in sentinel node? Eur J Cancer. 2017 Apr;75:167-8. https://doi.org/10.1016/j.ejca.2017.01.016
Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P, et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol. 2013 Apr;14(4):297-
https://doi.org/10.1016/S1470-2045(13)70035-4
Galimberti V, Chifu C, Rodriguez Perez S, Veronesi P, Intra M, Botteri E, et al. Positive axillary sentinel lymph node: is axillary dissection always necessary? Breast. 2011 Oct;20(Suppl. 3):S96-8. https://doi.org/10.1016/S0960-9776(11)70303-4
Houvenaeghel G, Resbeut M, Boher JM. Sentinel node invasion: is it necessary to perform axillary lymph node dissection?Randomized trial SERC. Bull Cancer. 2014;101(4):358-63. https://doi.org/10.1684/bdc.2014.1916
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2018 Antonio Cassio Assis Pellizzon
This work is licensed under a Creative Commons Attribution 4.0 International License.
