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Occult axillary lymph node metastases do not have prognostic significance in early stage breast cancer†
Article first published online: 25 AUG 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 6, pages 1507–1514, 15 March 2012
How to Cite
Wu, Y., Mittendorf, E. A., Kelten, C., Tucker, S. L., Wei, W., Middleton, L. P., Broglio, K., Buchholz, T. A., Hunt, K. K. and Sahin, A. A. (2012), Occult axillary lymph node metastases do not have prognostic significance in early stage breast cancer. Cancer, 118: 1507–1514. doi: 10.1002/cncr.26458
Istanbul Samatya Education and Research Hospital, Istanbul, Turkey.
- Issue published online: 2 MAR 2012
- Article first published online: 25 AUG 2011
- Manuscript Revised: 22 JUN 2011
- Manuscript Accepted: 22 JUN 2011
- Manuscript Received: 7 MAR 2011
- breast cancer;
- axillary lymph node;
- occult metastasis;
Axillary lymph node status is one of the most powerful prognostic indicators in patients with breast cancer and has implications for adjuvant treatment. It has been demonstrated that enhanced histologic evaluation of axillary lymph nodes, including serial sectioning of paraffin tissue blocks and immunohistochemical (IHC) staining, increases the rate of detection of occult metastases. The clinical significance of occult lymph node metastases has been the subject of debate.
In the current study, the authors identified 267 patients who underwent axillary lymph node dissection (ALND) between 1987 and 1995 and were lymph node negative according to a routine pathologic evaluation, which included the complete submission of all lymph nodes and an examination of 1 hematoxylin and eosin (H&E)-stained section per paraffin block. Patients did not receive systemic chemotherapy or hormone therapy. All of the dissected lymph nodes from these patients were re-evaluated by intensified pathologic methods (serial sectioning with H&E levels plus IHC). Occult metastases were categorized by detection method and size. The clinical significance of the occult metastases was determined.
Thirty-nine patients (15%) who had lymph node-negative results on routine evaluation of their ALND specimens had occult metastases identified. Eight of these patients (20%) had macrometastases >2.0 mm, 15 (40%) had micrometastases (range, >0.2 mm to ≤2 mm), and 16 (40%) had isolated tumor cells (≤0.2 mm). The presence of occult metastases and the size of metastases did not affect recurrence-free or overall survival.
The presence of occult metastasis did not have clinical significance in this cohort of patients with early stage breast cancer. Cancer 2011;. © 2011 American Cancer Society.