BACKGROUND: This retrospective study was designed to provide a preliminary outcome analysis in patients with positive sentinel nodes who declined axillary dissection. METHODS: A review was conducted of patients who underwent lumpectomy and sentinel lymph node excision for invasive disease between January 1998 and July 2000. Those who were found to have sentinel lymph node metastasis without completion axillary dissection were selected for evaluation. Follow-up included physical examination and mammography. RESULTS: Thirty-one patients were identified who met inclusion criteria. Primary invasive cell types included infiltrating ductal carcinoma, infiltrating lobular carcinoma, and mixed cellularity. Most primary tumors were T1. Nodal metastases were identified by hematoxylin and eosin stain and immunohistochemistry. Twenty-seven of the metastases were microscopic (<2 mm), and the remaining four were macroscopic. All patients received adjuvant systemic therapy. With a mean follow-up of 30 months, there have been no patients with axillary recurrence on physical examination or mammographic evaluation. CONCLUSIONS: We have presented patients with sentinel lymph nodes involved by cancer who did not undergo further axillary resection and remain free of disease at least 1 year later. This preliminary analysis supports the inclusion of patients with subclinical axillary disease in trials that randomize to observation alone.
BACKGROUND: This retrospective study was designed to provide a preliminary outcome analysis in patients with positive sentinel nodes who declined axillary dissection. METHODS: A review was conducted of patients who underwent lumpectomy and sentinel lymph node excision for invasive disease between January 1998 and July 2000. Those who were found to have sentinel lymph node metastasis without completion axillary dissection were selected for evaluation. Follow-up included physical examination and mammography. RESULTS: Thirty-one patients were identified who met inclusion criteria. Primary invasive cell types included infiltrating ductal carcinoma, infiltrating lobular carcinoma, and mixed cellularity. Most primary tumors were T1. Nodal metastases were identified by hematoxylin and eosin stain and immunohistochemistry. Twenty-seven of the metastases were microscopic (<2 mm), and the remaining four were macroscopic. All patients received adjuvant systemic therapy. With a mean follow-up of 30 months, there have been no patients with axillary recurrence on physical examination or mammographic evaluation. CONCLUSIONS: We have presented patients with sentinel lymph nodes involved by cancer who did not undergo further axillary resection and remain free of disease at least 1 year later. This preliminary analysis supports the inclusion of patients with subclinical axillary disease in trials that randomize to observation alone.
Authors: Julia Park; Jane V Fey; Arpana M Naik; Patrick I Borgen; Kimberly J Van Zee; Hiram S Cody Journal: Ann Surg Date: 2007-03 Impact factor: 12.969
Authors: Igor Langer; Ulrich Guller; Carsten T Viehl; Holger Moch; Edward Wight; Felix Harder; Daniel Oertli; Markus Zuber Journal: Indian J Surg Oncol Date: 2010-08-07
Authors: Marieke E Straver; Philip Meijnen; Geertjan van Tienhoven; Cornelis J H van de Velde; Robert E Mansel; Jan Bogaerts; Nicole Duez; Luigi Cataliotti; Jean H G Klinkenbijl; Helen A Westenberg; Huub van der Mijle; Marko Snoj; Coen Hurkmans; Emiel J T Rutgers Journal: Ann Surg Oncol Date: 2010-03-19 Impact factor: 5.344
Authors: Arpana M Naik; Jane Fey; Mary Gemignani; Alexandra Heerdt; Leslie Montgomery; Jeanne Petrek; Elisa Port; Virgilio Sacchini; Lisa Sclafani; Kimberly VanZee; Raquel Wagman; Patrick I Borgen; Hiram S Cody Journal: Ann Surg Date: 2004-09 Impact factor: 12.969