TY - JOUR
T1 - Sentinel and non-sentinel lymph node metastases in patients with microinvasive breast cancer
T2 - a nationwide study
AU - Holm-Rasmussen, Emil Villiam
AU - Jensen, Maj Britt
AU - Balslev, Eva
AU - Kroman, Niels
AU - Tvedskov, Tove Filtenborg
PY - 2019/6
Y1 - 2019/6
N2 - 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.
AB - 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.
KW - Axillary lymphnode metastases
KW - Axillary management
KW - Axillary surgery
KW - Early-stage breast cancer
KW - Microinvasive breast cancer
KW - Sentinel lymph node
KW - Sentinel lymph node biopsy
KW - Sentinel lymph node metastases
U2 - 10.1007/s10549-019-05200-4
DO - 10.1007/s10549-019-05200-4
M3 - Journal article
C2 - 30877405
AN - SCOPUS:85063031310
SN - 0167-6806
VL - 175
SP - 713
EP - 719
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
ER -
