High risk of non‐sentinel node metastases in a group of breast cancer patients with micrometastases in the sentinel node
Identifieur interne : 004772 ( Main/Exploration ); précédent : 004771; suivant : 004773High risk of non‐sentinel node metastases in a group of breast cancer patients with micrometastases in the sentinel node
Auteurs : Tove Filtenborg Tvedskov [Danemark] ; Maj-Britt Jensen [Danemark] ; Ida Marie Lisse [Danemark] ; Bent Ejlertsen [Danemark] ; Eva Balslev [Danemark] ; Niels Kroman [Danemark]Source :
- International Journal of Cancer [ 0020-7136 ] ; 2012-11-15.
Abstract
Axillary lymph node dissection (ALND) in breast cancer patients with positive sentinel nodes is under debate. We aimed to establish two models to predict non‐sentinel node (NSN) metastases in patients with micrometastases or isolated tumor cells (ITC) in sentinel nodes, to guide the decision for ALND. A total of 1,577 breast cancer patients with micrometastases and 304 with ITC in sentinel nodes, treated by sentinel lymph node dissection and ALND in 2002–2008 were identified in the Danish Breast Cancer Cooperative Group database. Risk of NSN metastases was calculated according to clinicopathological variables in a logistic regression analysis. We identified tumor size, proportion of positive sentinel nodes, lymphovascular invasion, hormone receptor status and location of tumor in upper lateral quadrant of the breast as risk factors for NSN metastases in patients with micrometastases. A model based on these risk factors identified 5% of patients with a risk of NSN metastases on nearly 40%. The model was however unable to identify a subgroup of patients with a very low risk of NSN metastases. Among patients with ITC, we identified tumor size, age and proportion of positive sentinel nodes as risk factors. A model based on these risk factors identified 32% of patients with risk of NSN metastases on only 2%. Omission of ALND would be acceptable in this group of patients. In contrast, ALND may still be beneficial in the subgroup of patients with micrometastases and a high risk of NSN metastases.
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DOI: 10.1002/ijc.27499
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We aimed to establish two models to predict non‐sentinel node (NSN) metastases in patients with micrometastases or isolated tumor cells (ITC) in sentinel nodes, to guide the decision for ALND. A total of 1,577 breast cancer patients with micrometastases and 304 with ITC in sentinel nodes, treated by sentinel lymph node dissection and ALND in 2002–2008 were identified in the Danish Breast Cancer Cooperative Group database. Risk of NSN metastases was calculated according to clinicopathological variables in a logistic regression analysis. We identified tumor size, proportion of positive sentinel nodes, lymphovascular invasion, hormone receptor status and location of tumor in upper lateral quadrant of the breast as risk factors for NSN metastases in patients with micrometastases. A model based on these risk factors identified 5% of patients with a risk of NSN metastases on nearly 40%. The model was however unable to identify a subgroup of patients with a very low risk of NSN metastases. Among patients with ITC, we identified tumor size, age and proportion of positive sentinel nodes as risk factors. A model based on these risk factors identified 32% of patients with risk of NSN metastases on only 2%. Omission of ALND would be acceptable in this group of patients. In contrast, ALND may still be beneficial in the subgroup of patients with micrometastases and a high risk of NSN metastases.</div></front></TEI><affiliations><list><country><li>Danemark</li></country><region><li>Hovedstaden</li></region><settlement><li>Copenhague</li></settlement></list><tree><country name="Danemark"><region name="Hovedstaden"><name sortKey="Tvedskov, Tove Filtenborg" sort="Tvedskov, Tove Filtenborg" uniqKey="Tvedskov T" first="Tove Filtenborg" last="Tvedskov">Tove Filtenborg Tvedskov</name></region><name sortKey="Balslev, Eva" sort="Balslev, Eva" uniqKey="Balslev E" first="Eva" last="Balslev">Eva Balslev</name><name sortKey="Ejlertsen, Bent" sort="Ejlertsen, Bent" uniqKey="Ejlertsen B" first="Bent" last="Ejlertsen">Bent Ejlertsen</name><name sortKey="Jensen, Maj Ritt" sort="Jensen, Maj Ritt" uniqKey="Jensen M" first="Maj-Britt" last="Jensen">Maj-Britt Jensen</name><name sortKey="Kroman, Niels" sort="Kroman, Niels" uniqKey="Kroman N" first="Niels" last="Kroman">Niels Kroman</name><name sortKey="Lisse, Ida Marie" sort="Lisse, Ida Marie" uniqKey="Lisse I" first="Ida Marie" last="Lisse">Ida Marie Lisse</name><name sortKey="Tvedskov, Tove Filtenborg" sort="Tvedskov, Tove Filtenborg" uniqKey="Tvedskov T" first="Tove Filtenborg" last="Tvedskov">Tove Filtenborg Tvedskov</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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