[159] 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.
Results:

 MicrometastasesIsolated Tumor Cells
Case number259
Tumor type*IDC-24; ILC-1IDC-4; ILC-3; DCIS-2
Tumor grade (I-III)I-2; II-18; III-5I-2; II-3; III-2; grade II DCIS-2
Tumor size (cm)0.7-50.2-1.8
LVIPresent-8; Absent-17All absent
Follow-up
Length8-96 months11-84 months
Additional axillary nodes12 cases had additional axillary node dissection, only 1 case had one additional node with micrometastasis.None performed
Local recurrence2/25 cases. Both had additional axillary node dissection with no additional positive node.None
Distant metastasis2/25 cases (1 had local recurrence before metastasis)None
Death2/25 casesNone
*IDC-invasive ductal carcinoma, ILC-invasive lobular carcinoma, DCIS-ductal carcinoma in-situ

Two patients developed distant metastases (lung, spine, liver, neck) 12 and 6 months after the primary breast cancer surgery and later died. Both cases had grade III invasive ductal carcinoma with LVI and negative estrogen receptor/progesterone receptor/Her-2/neu expressions (triple negative).
Conclusions: Completion axillary node dissection is not necessary in patients with micrometastases and ITCs in sentinel lymph nodes as it does not impact local recurrence. Finding of ITCs did not have prognostic significance. Micrometastasis, however, may be associated with distant metastasis in certain patients, especially when the primary tumor was high grade and triple negative.
Category: Breast

Monday, February 28, 2011 1:00 PM

Poster Session II # 33, Monday Afternoon

 

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