Extranodal extension of axillary metastasis of invasive breast carcinoma as a possible predictor for the total number of positive lymph nodes

Introduction: By the implementation of the sentinel node procedure in the treatment of breast carcinoma routine axillary lymph node, dissection can be abandoned in patients with a tumour-negative sentinel node. When the sentinel node is positive there are two options; an axillary dissection or radio...

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Bibliographic Details
Published in:European journal of surgical oncology 2001-12, Vol.27 (8), p.719-722
Main Authors: Palamba, H.W, Rombouts, M.C, Ruers, Th.J.M, Klinkenbijl, J.H.G, Wobbes, Th
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Axilla - pathology
breast cancer
Breast Neoplasms - pathology
Breast Neoplasms - radiotherapy
Breast Neoplasms - surgery
Chemotherapy, Adjuvant
extranodal extension
Female
Humans
Lymph Node Excision
Lymph Nodes - pathology
lymph-node metastasis
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Patient Care Planning
Predictive Value of Tests
Sentinel Lymph Node Biopsy
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Summary:Introduction: By the implementation of the sentinel node procedure in the treatment of breast carcinoma routine axillary lymph node, dissection can be abandoned in patients with a tumour-negative sentinel node. When the sentinel node is positive there are two options; an axillary dissection or radiotherapy of the axilla. In the latter case one is not informed about the total number of positive lymph nodes which can be of importance for the choice of adjuvant chemotherapy. In this paper we analyse whether it is possible to use histological parameters of a lymph-node metastasis to predict the number of tumour-cell-containing nodes. Methods: Four hundred and ninety-eight patients treated for invasive breast cancer at our department from 1991 to 1996 were investigated to see whether extranodal extension of axillary metastases had a significant predictive value for the number of positive lymph nodes. Extranodal extension was scored as: no extranodal extension (NEE) and extranodal extension (EE); the latter was subdivided in minimal extranodal extension (MEE) or extensive extranodal extension (EEE). Results: Of 498 patients, 230 patients had axillary involvement. NEE was seen in 83 (36.1%) patients and 147 (63.9%) had EE. Subdivision of this latter group revealed 77 patients with MEE (52%), 65 patients with EEE (45%) and five patients not further specified (3%). The number of positive nodes for the EE-group (6.9±0.5) was significant higher compared with the NEE-group (2.1±0.2) (P
ISSN:0748-7983
1532-2157
DOI:10.1053/ejso.2001.1173