Prognostic impact of macrometastasis linear size in sentinel node biopsy for breast carcinoma.

AIM: The aim of the present study was to evaluate the risk of axillary non-sentinel lymph-node metastases (ALN) in breast cancer patients presenting macrometastasis (Mac-m) in the sentinel lymph node (SN). MATERIALS AND METHODS: A retrospective series of 1464 breast cancers from patients who underwent ALN dissection following the diagnosis of Mac-m in the sentinel node (SN) was studied. In all the cases the MAC-m linear size was evaluated and correlated with presence or absence of non-SN ALN metastases. RESULTS: Non-SN metastases were detected in 644∖1464 cases (43.98%). The risk of further axillary metastases ranged from 20.2% (37/183) in cases with Mac-m between 2 and 2.9 mm, to 65.3% (262/401) in cases with Mac-m measuring > 10 mm. The risk of non-SN ALN metastases showed a 3% increase, parallel to each mm increment in SN metastasis size. The data evaluated with the receiver operating characteristic (ROC) curve showed that the Mac-m could be subdivided according to a new cut-off of 7 mm. pT1 tumours, with Mac-m < 7 mm had a risk of non-SN ALN metastases of <30%. Furthermore 109/127 of these (85.8%) had 3 or less non-SN ALN -metastases. CONCLUSIONS: The present data give a detailed description on the risk of non-SN ALN involvement, that may be useful in the evaluation of breast cancer patients. It is suggested that a Mac-m size of <7 mm is related to a low residual axillary disease burden in breast cancer patients with small (pT1) tumours.

[A case of bat rabies in a cat in the province of Buenos Aires, Argentina]. / Rabia debida a virus de murciélago en un gato de la Provincia de Buenos Aires, Argentina.

In the Central Laboratory of Public Health in Buenos Aires, rabies was detected in a cat that was brought in for diagnosis by its owners. The animal, which was displaying symptoms of the furious form of the disease, had attacked three people in the rural area of Chascomús, near the Rio de la Plata. All three of the people who had been bitten received the necessary treatment. The diagnosis was made using the fluorescent antibody test and the inoculation of mice and the results were communicated to the Zoonoses Division of the Ministry of Health. The virus was then typed at the Institute Pasteur of Buenos Aires using monoclonal antibodies, where it was found to be antigenic variant 4 of serotype 1, i.e., the type of virus usually found in insectivorous bats. This area has been free of the canine variant since 1984. This is the first known case in the province of Buenos Aires of a cat becoming infected with this type of virus. It confirms that there is a link between the air and terrestrial cycles of rabies in this area.