Outcomes of Breast Cancer Patients with Micrometastasis and Isolated Tumor Cells in Sentinel Lymph Nodes.
Nika C Gloyeske, Wamda Goreal, Maura O'Neil, Carol Connor, Ossama W Tawfik, Fang Fan. University of Kansas Medical Center, Kansas City
Background: The prognostic value and clinical implication of micrometastasis and isolated tumor cells (ITCs) in sentinel lymph nodes are still not clearly defined. This study was designed to collect follow up data on breast cancer patients with micrometastases and ITCs in their sentinel lymph nodes.
Design: Approximately 1000 sentinel lymph node biopsies were performed at our medical center between 2000 and 2010. Among them, 25 cases of micrometastasis (2.5%) and 9 cases of ITCs (0.9%) were identified. Patients treated with neoadjuvant chemotherapy were excluded from this study. Primary tumor type, grade, size, lymphovascular invasion (LVI), additional axillary lymph node information, tumor biomarkers, local and distant metastases as well as survival were recorded.
|Micrometastases||Isolated Tumor Cells|
|Tumor type*||IDC-24; ILC-1||IDC-4; ILC-3; DCIS-2|
|Tumor grade (I-III)||I-2; II-18; III-5||I-2; II-3; III-2; grade II DCIS-2|
|Tumor size (cm)||0.7-5||0.2-1.8|
|LVI||Present-8; Absent-17||All absent|
|Length||8-96 months||11-84 months|
|Additional axillary nodes||12 cases had additional axillary node dissection, only 1 case had one additional node with micrometastasis.||None performed|
|Local recurrence||2/25 cases. Both had additional axillary node dissection with no additional positive node.||None|
|Distant metastasis||2/25 cases (1 had local recurrence before metastasis)||None|