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Breast Cancer Research and Treatment

Published in:

01-06-2019 | Metastasis | Epidemiology

Sentinel and non-sentinel lymph node metastases in patients with microinvasive breast cancer: a nationwide study

Authors: Emil Villiam Holm-Rasmussen, Maj-Britt Jensen, Eva Balslev, Niels Kroman, Tove Filtenborg Tvedskov

Published in: Breast Cancer Research and Treatment | Issue 3/2019

Abstract

Purpose

To determine the incidence and risk factors of sentinel lymph node (SN) and non-SN metastases in patients with microinvasive breast cancer (MIBC, T1_mic). This to identify MIBC patients in whom axillary staging can be safely omitted.

Methods

The Danish Breast Cancer Group database was used to identify a total of 409 women with breast cancer ≤ 1 mm who underwent sentinel lymph node biopsy (SLNB) between 2002 and 2015. After validation, 233 patients were eligible for the analysis. The incidence rates of SN and non-SN metastases were determined. The associations between clinicopathological variables and a positive SN [pN1, pN1mi, or pN0(i+)] were analyzed using univariate and multivariate designs.

Results

Of 233 patients with MIBC, only 9 (3.9%) had SN macrometastases. An additional 18 (7.7%) and 23 (9.9%) had SN micrometastases and isolated tumor cells (ITCs), respectively. Of patients with SN macrometastases, two (22.2%) had non-SN macrometastases. In the adjusted analysis, a positive SN was associated with younger age (P = 0.0001) and a positive human epidermal growth factor 2 receptor (HER2) status (P = 0.03).

Conclusions

The low incidence of SN macrometastases < 4% suggests omission of axillary staging in MIBC patients without staging at primary surgery, especially in older (≥ 50 years) HER2⁻ patients. Still, the relatively high proportion of patients with non-SN macrometastases indicates that axillary treatment might be considered in SN positive patients, especially in younger HER2⁺ MIBC patients.

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Title: Sentinel and non-sentinel lymph node metastases in patients with microinvasive breast cancer: a nationwide study
Authors: Emil Villiam Holm-Rasmussen
Maj-Britt Jensen
Eva Balslev
Niels Kroman
Tove Filtenborg Tvedskov
Publication date: 01-06-2019
Publisher: Springer US
Keywords: Metastasis
Breast Cancer
Breast Cancer
Published in: Breast Cancer Research and Treatment / Issue 3/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-019-05200-4

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