Nonsentinel node metastases in breast cancer patients with isolated tumor cells in the sentinel node: Implications for completion axillary node dissection

Kristine E. Calhoun, Nora M. Hansen, Roderick R. Turner, Armando E. Giuliano*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

Background: Controversy exists regarding axillary dissection (ALND) for sentinel node (SLN) metastases detected as isolated tumor cells (ITC). We hypothesized that the number of positive non-SLNs is low and ALND is unnecessary for most patients with ITC. Methods: From 1995 to 1999, 634 breast cancer patients underwent SLND. SLNs were examined using immunohistochemistry if hematoxylin and eosin was negative. ALND was recommended for ITC-positive SLNs. Results: Seventy-eight patients (12.3%) with ITC-positive SLNs were offered ALND. Sixty-one consented, whereas 17 refused. Fifty-eight (95.1%) had negative non-SLNs. Three (4.9%) had non-SLN metastases. One patient (1.6%) had macrometastatic disease, whereas 2 (3.3%) had micrometastases. No ITC-only-positive SLN patient experienced axillary recurrence. Conclusions: When ALND was performed for ITC, 1.6% of non-SLNs harbored macrometastases and 3.3% had micrometastases. When ALND was not performed, axillary recurrence was not seen. The low risk of non-SLN disease in this study fails to support the routine use of ALND for ITC-positive SLNs.

Original languageEnglish (US)
Pages (from-to)588-591
Number of pages4
JournalAmerican journal of surgery
Volume190
Issue number4
DOIs
StatePublished - Oct 1 2005

Keywords

  • Axillary dissection
  • Invasive breast cancer
  • Isolated tumor cells
  • Sentinel lymphadenectomy

ASJC Scopus subject areas

  • Surgery

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