RESUMEN
BACKGROUND: The presence of lymph node metastases is the most important prognostic factor in early stage breast cancer. Whether bone marrow micrometastases (BMM) impact the prognosis in sentinel lymph node (SLN)-negative breast cancer patients remains a matter of debate. Therefore, the objective of this study was to assess the impact of BMM on 5-year disease-free and overall survival among those patients. METHODS: We analyzed 410 patients with early stage breast cancer (pT1 and pT2 ≤ 3 cm, cN0) who were prospectively enrolled into the Swiss Multicenter Sentinel Lymph Node Study in Breast Cancer between January 2000 and December 2003. All patients underwent bone marrow aspiration followed by SLN biopsy. All SLN were stained with hematoxylin and eosin and immunohistochemistry (Lu-5, CK-22). Cancer cells in the bone marrow were identified after staining with monoclonal antibodies A45-B/B3 against CK-8, -18, and -19. RESULTS: Negative SLN were found in 67.6% (277 of 410) of the enrolled patients. Of those, BMM status was negative in 75.8% (210 of 277) and positive in 24.2% (67 of 277) patients. Median follow-up was 61 (range 11-96) months. Five-year disease-free survival was 93.6% (95% confidence interval [CI] 89.1-96.0) in BMM-negative and 92.2% (95% CI 82.5-96.2) in BMM-positive patients (p = 0.50). Five-year overall survival was 92.7% (95% CI 87.9-95.8) for the BMM-negative and 92.5% (95% CI 83.4-96.2) for the BMM-positive group (p = 0.85). CONCLUSIONS: This is one of the first prospective studies to examine 5-year disease-free and overall survivals in SLN-negative patients in correlation to their BMM status. Although BMM are identified in one of four SLN-negative patients, they do not impact disease-free and overall survival.
Asunto(s)
Neoplasias de la Médula Ósea/mortalidad , Neoplasias de la Mama/mortalidad , Carcinoma Ductal de Mama/mortalidad , Carcinoma Lobular/mortalidad , Biopsia del Ganglio Linfático Centinela , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Médula Ósea/secundario , Neoplasias de la Médula Ósea/cirugía , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Carcinoma Ductal de Mama/secundario , Carcinoma Ductal de Mama/cirugía , Carcinoma Lobular/secundario , Carcinoma Lobular/cirugía , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Micrometástasis de Neoplasia , Estadificación de Neoplasias , Pronóstico , Estudios Prospectivos , Tasa de SupervivenciaRESUMEN
OBJECTIVE: To assess the accuracy of sentinel lymph node (SLN) frozen section in a prospective multicenter study of early-stage breast cancer patients. SUMMARY BACKGROUND DATA: The decision to perform an immediate completion axillary node dissection (ALND) is based on results of SLN frozen section. However, SLN frozen sections are not routinely performed in all centers. Moreover, the accuracy of SLN frozen section remains a matter of great debate. METHODS: Prospective multicenter trial analyzing 659 early stage breast cancer patients (pT1 and pT2 Asunto(s)
Neoplasias de la Mama/patología
, Ganglios Linfáticos/patología
, Biopsia del Ganglio Linfático Centinela
, Adulto
, Anciano
, Anciano de 80 o más Años
, Neoplasias de la Mama/diagnóstico por imagen
, Neoplasias de la Mama/cirugía
, Femenino
, Humanos
, Persona de Mediana Edad
, Estadificación de Neoplasias
, Selección de Paciente
, Posmenopausia
, Premenopausia
, Estudios Prospectivos
, Reproducibilidad de los Resultados
, Suiza
, Ultrasonografía
RESUMEN
BACKGROUND: The sentinel lymph node (SLN) status has proven to accurately reflect the remaining axillary lymph nodes and represents the most important prognostic factor. It is unknown whether an association exists between the SLN status and the presence of bone marrow (BM) micrometastases. The objective of the present investigation was to evaluate whether or not such an association exists. METHODS: In the present investigation 410 patients with early stage breast cancer (pT1 and pT2 Asunto(s)
Neoplasias de la Médula Ósea/secundario
, Neoplasias de la Mama/patología
, Biopsia del Ganglio Linfático Centinela
, Adulto
, Anciano
, Anciano de 80 o más Años
, Anticuerpos Monoclonales
, Neoplasias de la Médula Ósea/patología
, Colorantes
, Femenino
, Humanos
, Queratinas/análisis
, Queratinas Tipo I/análisis
, Queratinas Tipo II/análisis
, Metástasis Linfática/patología
, Persona de Mediana Edad
, Estadificación de Neoplasias
, Pronóstico
, Estudios Prospectivos
, Suiza
RESUMEN
OBJECTIVE: To assess the morbidity after sentinel lymph node (SLN) biopsy compared with SLN and completion level I and II axillary lymph node dissection (ALND) in a prospective multicenter study. SUMMARY BACKGROUND DATA: ALND after breast cancer surgery is associated with considerable morbidity. We hypothesized: 1) that the morbidity in patients undergoing SLN biopsy only is significantly lower compared with those after SLN and completion ALND level I and II; and 2) that SLN biopsy can be performed with similar intermediate term morbidity in academic and nonacademic centers. METHODS: Patients with early stage breast cancer (pT1 and pT2 Asunto(s)
Neoplasias de la Mama/patología
, Neoplasias de la Mama/cirugía
, Biopsia del Ganglio Linfático Centinela
, Adulto
, Anciano
, Anciano de 80 o más Años
, Neoplasias de la Mama/radioterapia
, Femenino
, Mortalidad Hospitalaria
, Humanos
, Escisión del Ganglio Linfático
, Metástasis Linfática
, Persona de Mediana Edad
, Morbilidad
, Estudios Prospectivos
, Dosificación Radioterapéutica
, Radioterapia Adyuvante
, Suiza