Prognostic impact of macrometastasis linear size in sentinel node biopsy for breast carcinoma

M. P. Foschini, R. Miglio, C. Quinn, B. Belgio, P. Regitnig, S. Bianchi, R. Nannini, H. Buerger, H. Kaya, I. Illyés, J. Kulka, C. A. Wells, J. De Gaetano, I. Lipeniece-Karele, G. Cserni

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Abstract

Aim The aim of the present study was to evaluate the risk of axillary non-sentinel lymph-node metastases (ALN) in breast cancer patients presenting macrometastasis (Mac-m) in the sentinel lymph node (SN). Materials and methods A retrospective series of 1464 breast cancers from patients who underwent ALN dissection following the diagnosis of Mac-m in the sentinel node (SN) was studied. In all the cases the MAC-m linear size was evaluated and correlated with presence or absence of non-SN ALN metastases. Results Non-SN metastases were detected in 644∖1464 cases (43.98%). The risk of further axillary metastases ranged from 20.2% (37/183) in cases with Mac-m between 2 and 2.9 mm, to 65.3% (262/401) in cases with Mac-m measuring > 10 mm. The risk of non-SN ALN metastases showed a 3% increase, parallel to each mm increment in SN metastasis size. The data evaluated with the receiver operating characteristic (ROC) curve showed that the Mac-m could be subdivided according to a new cut-off of 7 mm. pT1 tumours, with Mac-m < 7 mm had a risk of non-SN ALN metastases of <30%. Furthermore 109/127 of these (85.8%) had 3 or less non-SN ALN -metastases. Conclusions The present data give a detailed description on the risk of non-SN ALN involvement, that may be useful in the evaluation of breast cancer patients. It is suggested that a Mac-m size of <7 mm is related to a low residual axillary disease burden in breast cancer patients with small (pT1) tumours.

Original languageEnglish
Pages (from-to)1421-1427
Number of pages7
JournalEuropean Journal of Surgical Oncology
Volume43
Issue number8
DOIs
Publication statusPublished - Aug 1 2017

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Keywords

  • Axillary dissection
  • Axillary metastasis
  • Breast cancer
  • Macrometastasis
  • Sentinel node
  • Staging

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Foschini, M. P., Miglio, R., Quinn, C., Belgio, B., Regitnig, P., Bianchi, S., Nannini, R., Buerger, H., Kaya, H., Illyés, I., Kulka, J., Wells, C. A., De Gaetano, J., Lipeniece-Karele, I., & Cserni, G. (2017). Prognostic impact of macrometastasis linear size in sentinel node biopsy for breast carcinoma. European Journal of Surgical Oncology, 43(8), 1421-1427. https://doi.org/10.1016/j.ejso.2017.05.007